Lynn A Wollenberg, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046-008234 Issued in IL

Practice address

700 N Side SQ
Clinton, IL 61727-1657

Phone

(217) 935-6309

Fax

(217) 935-3612

NPI assigned

Jun 9, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

83.19 of 100Reported as group

Quality

99.36

Improvement activities

40

Cost

44.82

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Gailey Eye Clinic, LTD

  • Ophthalmic Technician/Technologist
  • Forsyth, IL
  • NPI 1184829814
  Medicare reassignment NPD
• Gailey Eye Clinic, LTD

  • Ophthalmic Technician/Technologist
  • Peoria, IL
  • NPI 1275738908
  NPD
• Gailey Eye Clinic, LTD

  • Ophthalmic Technician/Technologist
  • Watseka, IL
  • NPI 1437355419
  NPD
• Gailey Eye Clinic, LTD

  • Ophthalmic Technician/Technologist
  • Bloomington, IL
  • NPI 1932156445
  NPD (past)
• Prairie Eye Center, LTD

  • Ophthalmology Physician
  • Springfield, IL
  • NPI 1447222864

  Optometrist

  NPD (past)

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232496000000",
    "number": "1679514038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 N SIDE SQ",
            "city": "CLINTON",
            "state": "IL",
            "postal_code": "617271657",
            "telephone_number": "217-935-6309",
            "fax_number": "217-935-3612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 N SIDE SQ",
            "city": "CLINTON",
            "state": "IL",
            "postal_code": "617271657",
            "telephone_number": "217-935-6309",
            "fax_number": "217-935-3612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLLENBERG",
        "first_name": "LYNN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2009-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-008234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "01584010",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co
• Walgreen Co.
• Walmart Inc.
• Shae Michelle Wesley
• Erin Lee White-Fish
• Laura Yost, SLP
• Scott R Zaehler

• Optometrist in Clinton, IL
• Providers in Clinton, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2009; 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.
• 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.