Individual provider Active NPI

Eric D. Gericke, O.D.

  • Optometrist
  • Springfield, MO
National Provider Identifier
1598884884
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T02408 Issued in MO
Practice address
1518 E Battlefield St
Springfield, MO 65804-3704
Phone
(417) 881-5530
Fax
(417) 889-4071
NPI assigned
Mar 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X T02408 MO Primary

Addresses

Primary practice location

1518 E Battlefield St
Springfield, MO 65804-3704

Mailing address

1518 E Battlefield St
Springfield, MO 65804-3704
Phone (417) 881-5530

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120124000847 MO Practitioner - Optometry 5799952271 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
T02408MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Om Vision Services Inc, CurrentSince Jun 21, 2012 Accepting new patients
Om Vision Services Inc, CurrentSince Jun 21, 2012 Accepting new patients

Locations

1518 E Battlefield Rd
Springfield, MO 65804
Phone (417) 881-5530

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1598884884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1518 E BATTLEFIELD ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658043704",
            "telephone_number": "417-881-5530",
            "fax_number": "417-889-4071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1518 E BATTLEFIELD ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658043704",
            "telephone_number": "417-881-5530",
            "fax_number": "417-889-4071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERICKE",
        "first_name": "ERIC",
        "middle_name": "D.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T02408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.