Eye State Optometry, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

EYE STATE OPTOMETRY, LLC

Practice address

3105 Grand Ave
Ames, IA 50010-4604

Phone

(515) 441-8127

NPI assigned

Sep 19, 2018

Organization subpart

No

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

Authorized official

Name

Mallori PhillipsNPI 1326539826

Title

Optometrist/Owner

Phone

(515) 293-0708

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Locations

Practitioners 1

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

• Mallori Phillips, OD

  • Optometrist
  • Grimes, IA
  • NPI 1326539826
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1537315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537315200000",
    "number": "1477037000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 CYCLONE LN",
            "city": "MADRID",
            "state": "IA",
            "postal_code": "501567610",
            "telephone_number": "515-293-0708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3105 GRAND AVE",
            "city": "AMES",
            "state": "IA",
            "postal_code": "500104604",
            "telephone_number": "515-441-8127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE STATE OPTOMETRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-19",
        "last_updated": "2018-09-19",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "MALLORI",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "515-293-0708"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Aaron Etscheidt, M.D.
• Denise Nicole Evans, DDS
• Rilee Grace Ewing, RDN
• Expressions Dental of Iowa, PC
• Eye Care Optical, LLC
• Eyecare Partners, P.C.
• Eyemart Express LLC
• Jon Lowell Fagre, M.D.
• Family Chiropractic and Solutions Integrative Wellness Inc
• Family Healing Chiropractic, PLLC

• Clinic/Center in Ames, IA
• Providers in Ames, IA by specialty
• Clinic/Center in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2018; 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.