Organization Active NPI

Fetters Family Eye Care PC

  • Optometrist
  • Cedar Rapids, IA
National Provider Identifier
1730265117
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
02049 Issued in IA
Legal business name
FETTERS FAMILY EYE CARE PC
Practice address
3726 Queen CT SW Ste 201
Cedar Rapids, IA 52404-3906
Phone
(319) 390-4144
Fax
(319) 390-4674
NPI assigned
Oct 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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

Authorized official

Name
Dr. Sheila M Fetters, O.D.NPI 1043207434
Title
Owner-Doctor
Phone
(319) 390-4144

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 02049 IA Primary

Addresses

Primary practice location

3726 Queen CT SW Ste 201
Cedar Rapids, IA 52404-3906

Mailing address

3726 Queen CT SW Ste 201
Cedar Rapids, IA 52404-3906
Phone (319) 826-6691

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050920000685 IA Part B Supplier - Clinic/Group Practice 2961436993 Receives reassigned benefits from 2 practitioners
Practice locations: Cedar Rapids, IA

National Provider Directory

National Provider Directory

Locations

3726 Queen Ct SW
Ste 201
Cedar Rapids, IA 52404
Phone (319) 390-4144

2600 Edgewood Rd SW
Ste 376
Cedar Rapids, IA 52404
Phone (319) 390-4144

Practitioners & affiliated clinicians

Practitioners 3

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": "1161993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688947200000",
    "number": "1730265117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3726 QUEEN CT SW STE 201",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524043906",
            "telephone_number": "319-826-6691",
            "fax_number": "319-826-6694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3726 QUEEN CT SW STE 201",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524043906",
            "telephone_number": "319-390-4144",
            "fax_number": "319-390-4674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FETTERS FAMILY EYE CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-28",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A",
        "authorized_official_last_name": "FETTERS",
        "authorized_official_first_name": "SHEILA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER-DOCTOR",
        "authorized_official_telephone_number": "319-390-4144",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IA",
            "license": "02049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; 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.