Organization Active NPI

Vision Care Associates PC

  • Optometrist
  • Storm Lake, IA
National Provider Identifier
1528020773
Registry record updated Dec 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
VISION CARE ASSOCIATES PC
Practice address
600 Ontario St
Storm Lake, IA 50588-1845
Phone
(712) 732-3233
Fax
(712) 732-1866
NPI assigned
Apr 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2007

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

Authorized official

Name
Donovan L Crouch, O.D.NPI 1255315644
Title
Optomotrist
Phone
(712) 732-3233

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

600 Ontario St
Storm Lake, IA 50588-1845

Mailing address

PO Box 1407
Storm Lake, IA 50588-1407
Phone (712) 732-3233

Other identifiers 1

IdentifierTypeStateIssuer
1214304MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040322001033 IA Part B Supplier - Clinic/Group Practice 6507757457 Receives reassigned benefits from 5 practitioners
Practice locations: Storm Lake, IA
O20100930075861 IA DME Supplier - Physician - OptometristDME Supplier - Optician 6507757457 Practice locations: Storm Lake, IA

National Provider Directory

National Provider Directory

Locations

600 Ontario St
Storm Lake, IA 50588
Phone (712) 239-3937

1290 Lake Ave
Storm Lake, IA 50588
Phone (712) 732-3233

Practitioners & affiliated clinicians

Practitioners 6

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": "1144108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198800000000",
    "number": "1528020773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1407",
            "city": "STORM LAKE",
            "state": "IA",
            "postal_code": "505881407",
            "telephone_number": "712-732-3233",
            "fax_number": "712-732-1866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 ONTARIO ST",
            "city": "STORM LAKE",
            "state": "IA",
            "postal_code": "505881845",
            "telephone_number": "712-732-3233",
            "fax_number": "712-732-1866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISION CARE ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-04",
        "last_updated": "2007-12-28",
        "status": "A",
        "authorized_official_last_name": "CROUCH",
        "authorized_official_first_name": "DONOVAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OPTOMOTRIST",
        "authorized_official_telephone_number": "712-732-3233",
        "authorized_official_credential": "O.D."
    },
    "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": "1214304",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Storm Lake, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2007; 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.