Ryan Edwards, O.D.

Primary specialty

Vision Therapy OptometristTaxonomy code 152WV0400X

License

046010924 Issued in IL

Practice address

3965 75TH St # 105
Aurora, IL 60504-7925

Phone

(815) 260-6884

NPI assigned

Feb 7, 2014

Last updated

Mar 16, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Direct Mobile Vision, PLLC

  • Optometrist
  • Aurora, IL
  • NPI 1467072942
  Authorized official Same address or phone

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

{
    "created_epoch": "1391731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615852800000",
    "number": "1639593908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3965 75TH ST # 105",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605047925",
            "telephone_number": "815-260-6884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3965 75TH ST # 105",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605047925",
            "telephone_number": "815-260-6884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-07",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004791",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "IL",
            "license": "046010924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ecumenical Support Services for the Elderly Esse Center
• Angela Edger
• Riva Evette Edmonds-Bonner
• Edward Health Ventures
• Megan Edwards
• Rachael R Eertmoed, MS, CCC-SLP
• Austin Eicher
• Kelly A Einbecker, PT
• Sara Carolyn Ekner, PA-C
• Ibrahim Aiad Elagha

• Vision Therapy Optometrist in Aurora, IL
• Providers in Aurora, IL by specialty
• Vision Therapy Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.