Organization Active NPI

Bonebrake Vision & Eye Center LLC

  • Optometrist
  • Saint Joseph, MO
National Provider Identifier
1629271622
Registry record updated Nov 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T0248 Issued in MO
Legal business name
BONEBRAKE VISION & EYE CENTER LLC
Practice address
707 N 36TH St
Suite a
Saint Joseph, MO 64506-2968
Phone
(816) 279-5683
NPI assigned
Jun 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2016

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

Authorized official

Name
Dr. John Skeffington Bonebrake, O.D.
Title
Owner
Phone
(816) 279-5683

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X T0248 MO Primary

Addresses

Primary practice location

707 N 36TH St
Suite a
Saint Joseph, MO 64506-2968

Mailing address

707 N 36TH St
Suite a
Saint Joseph, MO 64506-2968
Phone (816) 279-5683

National Provider Directory

National Provider Directory

Locations

707 N 36th St
Ste A
Saint Joseph, MO 64506
Phone (816) 279-5683

NPI Registry JSON

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479340800000",
    "number": "1629271622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 N 36TH ST",
            "address_2": "SUITE A",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645062968",
            "telephone_number": "816-279-5683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 N 36TH ST",
            "address_2": "SUITE A",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645062968",
            "telephone_number": "816-279-5683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BONEBRAKE VISION & EYE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-07",
        "last_updated": "2016-11-17",
        "status": "A",
        "authorized_official_last_name": "BONEBRAKE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "SKEFFINGTON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "816-279-5683",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T0248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2016; 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.