Broadway Vision Center

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

046008462 Issued in IL

Legal business name

BROADWAY VISION CENTER

Practice address

926 Broadway St
Quincy, IL 62301-2730

Phone

(217) 222-6888

Fax

(217) 222-6975

NPI assigned

Jan 31, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Mervi Hannele Leyendeckers, O.D.

Title

Dr of Optometry

Phone

(217) 222-6888

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1201737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214352000000",
    "number": "1629256730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "926 BROADWAY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012730",
            "telephone_number": "217-222-6888",
            "fax_number": "217-222-6975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "926 BROADWAY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012730",
            "telephone_number": "217-222-6888",
            "fax_number": "217-222-6975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADWAY VISION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-31",
        "last_updated": "2008-06-25",
        "status": "A",
        "authorized_official_last_name": "LEYENDECKERS",
        "authorized_official_first_name": "MERVI",
        "authorized_official_middle_name": "HANNELE",
        "authorized_official_title_or_position": "DR OF OPTOMETRY",
        "authorized_official_telephone_number": "217-222-6888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": "046008462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1083711642",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hannah Marie Brice, CPHT
• Megan Sue Bridgeman, FNP-C
• Kathleen Brink, LPC
• Lindsay M Brink, D.O.
• Matthew T. Brink, DO
• Whitney Brock
• Ashley N. Brown, CNP
• Glenda Brown, NP
• Jacqueline Renee Brown, PHARMD
• Sara Brown, APRN

• Durable Medical Equipment & Medical Supplies in Quincy, IL
• Providers in Quincy, IL by specialty
• Durable Medical Equipment & Medical Supplies in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.