Myron Allen Ryther, O.D. – Optometrist

Key facts

NPI: 1629148358
Entity type: Individual (NPI type 1)
Primary specialty: Optometrist 152W00000X
License: 1765 (IA)
Practice address: 501 S White St Ste 21
Mt Pleasant, IA 52641-2600
Phone: (319) 385-2020
Fax: (319) 385-6784
NPI assigned: Nov 9, 2006
Sex: Male
Sole proprietor: No

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
1765	IA	MD	Optometrist

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Optometrist	152W00000X	1765	IA	Yes

Addresses

Primary practice location

501 S White St Ste 21
Mt Pleasant, IA 52641-2600

Mailing address

501 S White St Ste 21
Mt Pleasant, IA 52641-2600
Phone (319) 385-2020

Other identifiers

Identifier	Type	State	Issuer
0206940001	Other	IA	DMERC
0149674	Medicaid	IA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629148358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S WHITE ST STE 21",
            "city": "MT PLEASANT",
            "state": "IA",
            "postal_code": "526412600",
            "telephone_number": "319-385-2020",
            "fax_number": "319-385-6784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S WHITE ST STE 21",
            "city": "MT PLEASANT",
            "state": "IA",
            "postal_code": "526412600",
            "telephone_number": "319-385-2020",
            "fax_number": "319-385-6784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYTHER",
        "first_name": "MYRON",
        "middle_name": "ALLEN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "1765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "0206940001",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0149674",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, IA

All providers in Mt Pleasant, IA · Optometrist in Iowa

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.