Rachel V Mortenson OD PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

02165 Issued in IA

Legal business name

RACHEL V MORTENSON OD PC

Practice address

208 8TH Ave SE
Oelwein, IA 50662-2448

Phone

(319) 283-3628

NPI assigned

May 30, 2007

Last updated

Mar 19, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Rachel V Mortenson, ODNPI 1679544696

Title

Owner

Phone

(319) 283-3628

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IA2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Rachel V Mortenson, O.D.

  • Optometrist
  • Oelwein, IA
  • NPI 1679544696
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205884800000",
    "number": "1669673356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 8TH AVE SE",
            "city": "OELWEIN",
            "state": "IA",
            "postal_code": "506622448",
            "telephone_number": "319-283-3628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 8TH AVE SE",
            "city": "OELWEIN",
            "state": "IA",
            "postal_code": "506622448",
            "telephone_number": "319-283-3628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RACHEL V MORTENSON OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2008-03-19",
        "status": "A",
        "authorized_official_last_name": "MORTENSON",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "319-283-3628",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IA",
            "license": "02165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1262402",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA-RR MEDICARE",
            "identifier": "DC6408",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Melissa A Reid
• Caitlin M Reinking, PHARMD
• Jenna Lea Schares, DDS

• Optometrist in Oelwein, IA
• Providers in Oelwein, IA by specialty
• Optometrist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.