Ava Rose Eyecare LTD

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

AVA ROSE EYECARE LTD

Doing business as

Precision Family Eyecare

Practice address

1115 N Henderson St
Galesburg, IL 61401-2523

Phone

(309) 343-1107

Fax

(309) 343-1306

NPI assigned

Jun 26, 2015

Last updated

Jun 26, 2015By 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

Nathan C Dieckow, ODNPI 1841423753

Title

President

Phone

(314) 599-1034

Specialties & licenses 1

Addresses

Other names 1

• Precision Family Eyecare Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

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.

• Nathan Curtis Dieckow, O.D.

  • Optometrist
  • Galesburg, IL
  • NPI 1841423753
  Medicare reassignment NPD Authorized official
• Daniel W Sherwood, OD

  • Optometrist
  • Galesburg, IL
  • NPI 1700897543
  NPD (past)

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

{
    "created_epoch": "1435276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435276800000",
    "number": "1609258581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 N HENDERSON ST",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614012523",
            "telephone_number": "309-343-1107",
            "fax_number": "309-343-1306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 N HENDERSON ST",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614012523",
            "telephone_number": "309-343-1107",
            "fax_number": "309-343-1306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVA ROSE EYECARE LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-26",
        "last_updated": "2015-06-26",
        "status": "A",
        "authorized_official_last_name": "DIECKOW",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-599-1034",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Precision Family Eyecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Aperion Care Galesburg North
• Fares Aris
• Vijay K Arora, MD
• Jayalakshmi Attaluri, MD
• Linda M Auer, DO
• Susie Marie Avery, APRN
• Chris M Ayers, CNS
• Robert Ayers
• Azer III, P.C. (Azer Clinic)
• Azer Medical Supply, Inc.

• Optometrist in Galesburg, IL
• Providers in Galesburg, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2015; 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.