NPIMap

Organization Active NPI

Eye Care Associates of Co LLC

Doing business as Creston Vision Clinic

  • Optometrist
  • Creston, IA
National Provider Identifier
1548023518
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
EYE CARE ASSOCIATES OF CO LLC
Doing business as
Creston Vision Clinic
Practice address
1610 W Townline St
Creston, IA 50801-1066
Phone
(641) 782-7619
NPI assigned
Feb 2, 2024
Last updated
Feb 2, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
EYE CARE ASSOCIATES OF CO LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

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

Authorized official

Name
David Deppen
Title
Senior Director, Revenue Cycle Mana
Phone
(937) 539-8057

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

1610 W Townline St
Creston, IA 50801-1066

Mailing address

PO Box 879
Fort Washington, PA 19034-0879

Other names 1

  • Creston Vision Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230517001819 IA DME Supplier - Physician - Optometrist 9537597828 1 other NPI on this enrollment
Practice locations: Creston, IA

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Eye Care Associates of Co34 organizations share this tax ID, including this one
Part of
Eye Care Associates of Co

Other organizations with this tax ID 33

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

View all 33

Locations

655 S Federal Blvd
Unit De
Denver, CO 80219
Phone (720) 812-9004

8585 W 14th Ave
Ste C
Lakewood, CO 80215
Phone (303) 238-4357

200 Army Post Rd
Ste 16
Des Moines, IA 50315
Phone (515) 287-5565

1905 Ep True Pkwy
West Des Moines, IA 50265
Phone (515) 225-0877

15640 Don Lochman Ln
Ste C
Charlotte, NC 28277
Phone (704) 923-5797

7745 Ballantyne Commons Pkwy
Ste 101
Charlotte, NC 28277
Phone (704) 841-3937

7865 Trinity Rd
Ste 104
Cordova, TN 38018
Phone (901) 753-7100

5119 Summer Ave
Ste 101
Memphis, TN 38122
Phone (901) 761-2829

Practitioners & affiliated clinicians

Practitioners 96

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.

View all 96

NPI Registry JSON

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

{
    "created_epoch": "1706832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706832000000",
    "number": "1548023518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 879",
            "city": "FORT WASHINGTON",
            "state": "PA",
            "postal_code": "190340879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 W TOWNLINE ST",
            "city": "CRESTON",
            "state": "IA",
            "postal_code": "508011066",
            "telephone_number": "641-782-7619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE CARE ASSOCIATES OF CO LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EYE CARE ASSOCIATES OF CO LLC",
        "enumeration_date": "2024-02-02",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A",
        "authorized_official_last_name": "DEPPEN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "SENIOR DIRECTOR, REVENUE CYCLE MANA",
        "authorized_official_telephone_number": "937-539-8057"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Creston Vision Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Creston, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2024; 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.