Modern Optical

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

MODERN OPTICAL

Practice address

206 Euclid Ave
Des Moines, IA 50313-4404

Phone

(515) 282-8808

Fax

(515) 280-1182

NPI assigned

Feb 28, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Van DB Clark Jr

Title

Owner

Phone

(515) 282-8808

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lincoln Matthew Geren, O.D.

  • Optometrist
  • Des Moines, IA
  • NPI 1306860077
  NPD (past)
• Scott Steven Propsom, O.D.

  • Optometrist
  • Ankeny, IA
  • NPI 1497823819
  NPD (past)
• Jesse David Westrum, O.D.

  • Optometrist
  • Des Moines, IA
  • NPI 1093001091
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417085903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 EUCLID AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503134404",
            "telephone_number": "515-282-8808",
            "fax_number": "515-280-1182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 EUCLID AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503134404",
            "telephone_number": "515-282-8808",
            "fax_number": "515-280-1182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CLARK JR",
        "authorized_official_first_name": "VAN",
        "authorized_official_middle_name": "DB",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "515-282-8808"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "IA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0038307",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Moberg, M.D.
• Wendy S Mobley, PHARMD
• Jennifer L Mockus, ARNP
• Modern Day Counseling LLC
• Modern Muse, LLC (Modern Muse Massage)
• Abbey Lyn Modlin, ARNP
• Lynne D'Lanie Moeller
• Dean W. Moews, M.D.
• Walter Mogeni, MD
• Vivian Marie Mogensen, LISW

• Customized Equipment (DME) in Des Moines, IA
• Providers in Des Moines, IA by specialty
• Customized Equipment (DME) in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.