NPIMap

Organization Active NPI

International Eyecare Center, Inc.

Doing business as Malbar Vision

  • Optometrist
  • La Vista, NE
National Provider Identifier
1740461979
Registry record updated Jan 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
INTERNATIONAL EYECARE CENTER, INC.
Doing business as
Malbar Vision
Practice address
8102 S 84TH St
Lavista, NE 68128-3305
Phone
(402) 339-5550
Fax
(402) 339-5554
NPI assigned
Nov 15, 2007
Last updated
Jan 22, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2021

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

Authorized official

Name
Cathy Lee Short
Title
Credentialing Manager
Phone
(618) 462-9818

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary
Eyewear Supplier 332H00000X 470486594 NE

Addresses

Primary practice location

8102 S 84TH St
Lavista, NE 68128-3305

Mailing address

409 N 78TH St
Omaha, NE 68114-3638
Phone (402) 393-4500

Other names 1

  • Malbar Vision Doing business as

National Provider Directory

National Provider Directory
Tax ID family
International Eyecare Center Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

1400 Forum Blvd
Columbia, MO 65203
Phone (573) 446-0331

2011 Corona Rd
Columbia, MO 65203
Phone (314) 523-3480

2011 Corona Rd
Ste 201
Columbia, MO 65203
Phone (573) 447-2020

1877 N Bluff St
Ste A
Fulton, MO 65251

1702 N Baltimore St
Kirksville, MO 63501
Phone (660) 665-5674

7410 Remcon Cir
El Paso, TX 79912

1200 E Campbell Rd
#679402
Richardson, TX 75081

Practitioners & affiliated clinicians

Practitioners 22

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.

View all 22

NPI Registry JSON

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

{
    "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": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Malbar Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in La Vista, NE

Sources for this page

  • 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.