Washington Eye Care Center

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

WASHINGTON EYE CARE CENTER

Practice address

801 Buck St
Tiffin, IA 52340-9446

Phone

(319) 545-2252

Fax

(319) 545-2436

NPI assigned

Feb 5, 2019

Organization subpart

No

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

Authorized official

Name

Mrs. Beth A Gutierrez

Title

Billing Manager

Phone

(319) 653-4558

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Axis Vision Care Doing business as

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

{
    "created_epoch": "1549324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605571200000",
    "number": "1699230581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70",
            "city": "WASHINGTON",
            "state": "IA",
            "postal_code": "523530070",
            "telephone_number": "319-653-4558",
            "fax_number": "319-653-2574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 BUCK ST",
            "city": "TIFFIN",
            "state": "IA",
            "postal_code": "523409446",
            "telephone_number": "319-545-2252",
            "fax_number": "319-545-2436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHINGTON EYE CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-05",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A",
        "authorized_official_last_name": "GUTIERREZ",
        "authorized_official_first_name": "BETH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "319-653-4558",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3204843",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2700065",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Axis Vision Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Axis Vision Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Tiffin, IA
• Optometrist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; 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.