NPIMap

Organization Active NPI

Grene Vision Group LLC

  • Optometrist
  • Andover, KS
National Provider Identifier
1598977464
Registry record updated Jul 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
GRENE VISION GROUP LLC
Practice address
135 S Andover Rd
Andover, KS 67002-8037
Phone
(316) 733-4322
Fax
(316) 733-5860
NPI assigned
May 4, 2007
Last updated
Jul 28, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2011

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

Authorized official

Name
Sheryl Davenport
Title
Insurance Department Supervisor
Phone
(316) 858-3831

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X Primary
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X

Addresses

Primary practice location

135 S Andover Rd
Andover, KS 67002-8037

Mailing address

1851 N Webb Rd
Attn FLR2
Wichita, KS 67206-3413
Phone (316) 636-2010

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040407000095 KS Part B Supplier - Clinic/Group Practice 1254324023 Receives reassigned benefits from 45 practitioners
26 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wellington, KS; Wichita, KS; Winfield, KS; Yates Center, KS; El Dorado, KS; Neodesha, KS; Lyons, KS; Hutchinson, KS…

Other NPIs on the same Medicare enrollment 26

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

View all 26

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Grene Vision Group135 S Andover Rd, Andover, KS 67002-8037(316) 733-4322 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since May 8, 2021

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311811200000",
    "number": "1598977464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1851 N WEBB RD",
            "address_2": "ATTN FLR2",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672063413",
            "telephone_number": "316-636-2010",
            "fax_number": "316-691-4408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 S ANDOVER RD",
            "city": "ANDOVER",
            "state": "KS",
            "postal_code": "670028037",
            "telephone_number": "316-733-4322",
            "fax_number": "316-733-5860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRENE VISION GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2011-07-28",
        "status": "A",
        "authorized_official_last_name": "DAVENPORT",
        "authorized_official_first_name": "SHERYL",
        "authorized_official_title_or_position": "INSURANCE DEPARTMENT SUPERVISOR",
        "authorized_official_telephone_number": "316-858-3831"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Andover, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.