Organization Active NPI

Premier Eyecare & Eyewear

  • Optometrist
  • Grandview, MO
National Provider Identifier
1669700514
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
PREMIER EYECARE & EYEWEAR
Practice address
12220 Blue Ridge Ext Ste J
Grandview, MO 64030-1175
Phone
(816) 761-6337
Fax
(816) 761-3564
NPI assigned
Dec 3, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2025

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

Authorized official

Name
Christ D Dawson, OD
Title
Owner,MGR,OD
Phone
(816) 761-6337

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X Primary
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X

Addresses

Primary practice location

12220 Blue Ridge Ext Ste J
Grandview, MO 64030-1175

Mailing address

12220 Blue Ridge Ext Ste J
Grandview, MO 64030-1175
Phone (816) 761-6337

Other names 1

  • Premier Eyecare & Eyewear LLC Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100316000695 MO Part B Supplier - Clinic/Group Practice 7214062223 Receives reassigned benefits from 2 practitioners
Practice locations: Grandview, MO

National Provider Directory

National Provider Directory
Tax ID family
Hometown Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1259798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746576000000",
    "number": "1669700514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12220 BLUE RIDGE EXT STE J",
            "city": "GRANDVIEW",
            "state": "MO",
            "postal_code": "640301175",
            "telephone_number": "816-761-6337",
            "fax_number": "816-761-3564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12220 BLUE RIDGE EXT STE J",
            "city": "GRANDVIEW",
            "state": "MO",
            "postal_code": "640301175",
            "telephone_number": "816-761-6337",
            "fax_number": "816-761-3564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER EYECARE & EYEWEAR",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-03",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A",
        "authorized_official_last_name": "DAWSON",
        "authorized_official_first_name": "CHRIST",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER,MGR,OD",
        "authorized_official_telephone_number": "816-761-6337",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Eyecare & Eyewear LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Grandview, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.