Amy J S Daiber OD PA

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

AMY J S DAIBER OD PA

Practice address

204 N Front St
Daiber Vision Care
Dardanelle, AR 72834-3824

Phone

(479) 967-6113

Fax

(479) 968-6932

NPI assigned

Feb 5, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Amy Jeanine Daiber, ODNPI 1609926344

Title

President

Phone

(479) 967-6113

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Daiber Vision Care Doing business as

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Amy J S Daiber OD PA

  • Optometrist
  • Russellville, AR
  • NPI 1669512943

  O20051103001212

  Same enrollment

Tax ID family

Amy J S Daiber OD PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Amy J S Daiber OD PA

  • Optometrist
  • Russellville, AR
  • NPI 1669512943
  NPD tax ID

Locations

Practitioners 2

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

• Amy Jeanine Daiber, OD

  • Optometrist
  • Russellville, AR
  • NPI 1609926344
  NPD Authorized official
• Lori J Canfield, OD

  • Optometrist
  • Russellville, AR
  • NPI 1083752570
  NPD

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242604800000",
    "number": "1467590950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 N FRONT ST",
            "city": "DARDANELLE",
            "state": "AR",
            "postal_code": "728343824",
            "telephone_number": "479-229-1467",
            "fax_number": "479-229-1260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 N FRONT ST",
            "address_2": "DAIBER VISION CARE",
            "city": "DARDANELLE",
            "state": "AR",
            "postal_code": "728343824",
            "telephone_number": "479-967-6113",
            "fax_number": "479-968-6932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMY J S DAIBER OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2009-05-18",
        "status": "A",
        "authorized_official_last_name": "DAIBER",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "JEANINE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "479-967-6113",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1224667722",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD GR",
            "identifier": "48605",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Daiber Vision Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Arkansas Valley Chiropractic Clinic,P.a.
• Linda Jo Bankston, AADC, LADAC, LMSW,
• Lauren Kathryn Barefield, LCSW
• Christa Bartlett
• Bradley Bibb, MD PLLC

• All providers in Dardanelle, AR
• Optometrist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.