Individual provider Active NPI

John Meurer

  • Optometrist
  • Green Bay, WI
National Provider Identifier
1649222571
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2163 Issued in WI
Practice address
1001 Cormier Rd
Green Bay, WI 54304-4404
Phone
(920) 499-5873
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2163 WI Primary

Addresses

Primary practice location

1001 Cormier Rd
Green Bay, WI 54304-4404

Mailing address

101 S Military Ave # 250
Green Bay, WI 54303-2409
Phone (920) 660-6970

Other identifiers 1

IdentifierTypeStateIssuer
38579200MedicaidWI

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2163WIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Shopko Stores Operating Co. LLC Past Accepting new patients
Shopko Stores Operating Co LLC Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1649222571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 S MILITARY AVE # 250",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543032409",
            "telephone_number": "920-660-6970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 CORMIER RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543044404",
            "telephone_number": "920-499-5873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEURER",
        "first_name": "JOHN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2163",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38579200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; 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.