Alexander Eye Institute, SC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

30180 Issued in WI

Legal business name

ALEXANDER EYE INSTITUTE, SC

Practice address

250 N Metro Drive
Appleton, WI 54913-8571

Phone

(920) 830-2020

Fax

(920) 830-1118

NPI assigned

Feb 27, 2007

Last updated

May 4, 2010By 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

Mrs. Kimberly Kay Goddard, COT/ROOB

Title

Ophthalmic Technician

Phone

(920) 830-2020

Specialties & licenses 1

Addresses

Other names 1

• Alexander Eye Institute Former legal business name

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

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

CLIA laboratory certificates

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.

• Avery Delvin Alexander, MD

  • Ophthalmology Physician
  • Appleton, WI
  • NPI 1982788030
  Medicare reassignment NPD

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272931200000",
    "number": "1740317841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N METRO DRIVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138571",
            "telephone_number": "920-830-2020",
            "fax_number": "920-830-1118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 N METRO DRIVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138571",
            "telephone_number": "920-830-2020",
            "fax_number": "920-830-1118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEXANDER EYE INSTITUTE, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2010-05-04",
        "status": "A",
        "authorized_official_last_name": "GODDARD",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "OPHTHALMIC TECHNICIAN",
        "authorized_official_telephone_number": "920-830-2020",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "COT/ROOB"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "WI",
            "license": "30180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alexander Eye Institute",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Rana Sameer Alahmedi
• Maurizio Zeki Albala, M.D.
• Jordyn Albrecht, MGCS, CGC
• Gregory A. Aleff, LCSW
• Kayla Aleson, MSW
• Alexander Eye Surgery Center, LLC
• Avery Delvin Alexander, MD
• Heather Alford
• Syed Taimur Ali, M.D.
• Alissa Edwards DDS LLC

• Ophthalmology Physician in Appleton, WI
• Providers in Appleton, WI by specialty
• Ophthalmology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2010; 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.