Carthage Vision Clinic LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

T03101 Issued in MO

Legal business name

CARTHAGE VISION CLINIC LLC

Practice address

2020 S Garrison Ave
Carthage, MO 64836-3687

Phone

(417) 359-0600

Fax

(417) 359-0601

NPI assigned

Mar 13, 2015

Last updated

Apr 5, 2016By 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

Dr. Gregory Joseph Goetzinger, O.D.NPI 1013940477

Title

Member

Phone

(417) 359-0600

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 2

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.

• Gregory J. Goetzinger, OD

  • Optometrist
  • Carthage, MO
  • NPI 1013940477
  Medicare reassignment Care Compare group NPD Authorized official
• Shelby Nicole Baugh Bruner, OD

  • Optometrist
  • Carthage, MO
  • NPI 1407385701
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1426204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459814400000",
    "number": "1487047536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 S GARRISON AVE",
            "city": "CARTHAGE",
            "state": "MO",
            "postal_code": "648363687",
            "telephone_number": "417-359-0600",
            "fax_number": "417-359-0601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 S GARRISON AVE",
            "city": "CARTHAGE",
            "state": "MO",
            "postal_code": "648363687",
            "telephone_number": "417-359-0600",
            "fax_number": "417-359-0601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARTHAGE VISION CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-13",
        "last_updated": "2016-04-05",
        "status": "A",
        "authorized_official_last_name": "GOETZINGER",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "417-359-0600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T03101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC NORIDIAN PTAN",
            "identifier": "7473660001",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "MA5504",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "DV9359",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carthage R-9 School District
• Carthage Radiologosts
• Carthage Rehab, LLC
• Carthage Resdeintal, LLC (Maple Tree Terrace)
• Carthage Therapy LLC
• Caroline R Charlton
• Elaine G Childs, LPC
• Barbara G. Chilton, DO
• Maria Leneth Erispe Choca, PT
• Michael A Clark, LCSW

• Optometrist in Carthage, MO
• Providers in Carthage, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2016; 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.