International Eyecare Center, Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

INTERNATIONAL EYECARE CENTER, INC.

Practice address

8102 S 84TH St
Lavista, NE 68128-3305

Phone

(402) 339-5550

Fax

(402) 339-5554

NPI assigned

Nov 15, 2007

Organization subpart

No

Name

Cathy Lee Short

Title

Credentialing Manager

Phone

(618) 462-9818

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

• International Eyecare Center Inc

  • Optometrist
  • Omaha, NE
  • NPI 1649451980
  NPD tax ID
• International Eyecare Center Inc

  • Optometrist
  • Omaha, NE
  • NPI 1831368133
  NPD tax ID
• International Eyecare Center Inc

  • Optometrist
  • Winterset, IA
  • NPI 1891345989
  NPD tax ID
• International Eyecare Center, Inc.

  • Optometrist
  • Memphis, MO
  • NPI 1467738724
  NPD tax ID

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

• Cameron Joseph Bargell, OD

  • Optometrist
  • Omaha, NE
  • NPI 1275116360
  NPD (past)
• Logan Arnold Blowers

  • Optometrist
  • Lincoln, NE
  • NPI 1558125302
  NPD (past)
• Brian Cain, OD

  • Optometrist
  • Omaha, NE
  • NPI 1871658252
  NPD (past)
• Alan P Eschmann, O.D.

  • Optometrist
  • Omaha, NE
  • NPI 1881888238
  NPD (past)
• Stephen Philip Gildersleeve, O.D.

  • Optometrist
  • Lincoln, NE
  • NPI 1861706509
  NPD (past)
• Nicole Jerolyn Graham

  • Optometrist
  • Lincoln, NE
  • NPI 1528822376
  NPD (past)
• Valerie A Leff, OD

  • Optometrist
  • Omaha, NE
  • NPI 1821659319
  NPD (past)
• Kirk C. Maynard, OD

  • Optometrist
  • Omaha, NE
  • NPI 1902891096
  NPD (past)
• Jacob Oliver Weber, OD

  • Optometrist
  • Lincoln, NE
  • NPI 1447870258
  NPD (past)
• Maricela Cantuna, OD

  • Optometrist
  • Lodi, NJ
  • NPI 1164255790
  NPD (past)
• Calvin William Daack, OD

  • Optometrist
  • Fort Madison, IA
  • NPI 1386319705
  NPD (past)
• Mason M Garbs, OD

  • Optometrist
  • Quincy, IL
  • NPI 1548908072
  NPD (past)

Tax ID family

International Eyecare Center Inc (5 organizations share this tax ID)

Locations

• Malbar Vision Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 22, 2021.

{
    "created_epoch": "1195084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611273600000",
    "number": "1740461979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 N 78TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681143638",
            "telephone_number": "402-393-4500",
            "fax_number": "402-393-7457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8102 S 84TH ST",
            "city": "LAVISTA",
            "state": "NE",
            "postal_code": "681283305",
            "telephone_number": "402-339-5550",
            "fax_number": "402-339-5554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNATIONAL EYECARE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-15",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A",
        "authorized_official_last_name": "SHORT",
        "authorized_official_first_name": "CATHY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "618-462-9818"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NE",
            "license": "470486594",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47048659409",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Malbar Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Robert M Faulk, M.D.
• Robert Gall, LMHP, LPC, LADC, MA
• Amanda Jo Hebner, PLMHP
• John D Hill, LMHP, PLADC
• Holl Family Chiropractic
• Jeremy Jacob Janssen, D.P.T
• Betty Jean Ketchmark, PHARMD RP
• Roger A Klassen, OD
• Donald R Krysl, OD
• Thomas E Lewis, DDS

• All providers in Lavista, NE
• Optometrist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2021; 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.