Organization Active NPI

Jeff Wertz

  • Optician
  • Plainview, TX
National Provider Identifier
1447428701
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
Legal business name
JEFF WERTZ
Practice address
1001 N I-27 Ste 206
Plainview, TX 79072-3903
Phone
(806) 296-7175
Fax
(806) 296-0633
NPI assigned
Feb 20, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

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

Authorized official

Name
Mr. Jeffrey Wayne WertzNPI 1316961519
Title
Owner
Phone
(806) 296-7175

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OpticianGroup: 193400000X SINGLE SPECIALTY GROUP 156FX1800X Primary

Addresses

Primary practice location

1001 N I-27 Ste 206
Plainview, TX 79072-3903

Mailing address

1001 N I-27 Ste 206
Plainview, TX 79072-3903
Phone (806) 296-7175

Other identifiers 1

IdentifierTypeStateIssuer
0662777-03MedicaidTX

Other names 1

  • Eyewear Outlet Doing business as

National Provider Directory

National Provider Directory

Locations

1001 N Interstate 27
Ste 206
Plainview, TX 79072
Phone (806) 296-7175

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1203465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214352000000",
    "number": "1447428701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 N I-27 STE 206",
            "city": "PLAINVIEW",
            "state": "TX",
            "postal_code": "790723903",
            "telephone_number": "806-296-7175",
            "fax_number": "806-296-0633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 N I-27 STE 206",
            "city": "PLAINVIEW",
            "state": "TX",
            "postal_code": "790723903",
            "telephone_number": "806-296-7175",
            "fax_number": "806-296-0633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFF WERTZ",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-20",
        "last_updated": "2008-06-25",
        "status": "A",
        "authorized_official_last_name": "WERTZ",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "806-296-7175",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0662777-03",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eyewear Outlet",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Plainview, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; 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.