Boone Vision Center LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

IA1854 Issued in IA

Legal business name

BOONE VISION CENTER LLC

Practice address

621 Story St
Boone, IA 50036-2833

Phone

(515) 432-2973

Fax

(515) 432-1811

NPI assigned

Nov 11, 2005

Last updated

Jul 24, 2008By 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

Dr. Jeffrey Craig Anderson, ODNPI 1760466098

Title

Owner Optometrist

Phone

(515) 432-2973

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IA2 enrollments

Enrollment records 2

Tax ID family

Boone Vision Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Boone Vision Center

  • Clinic/Center
  • Boone, IA
  • NPI 1568997435
  NPD tax ID

Locations

Practitioners 3

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.

• Casey Matthew Roelfs, O.D.

  • Optometrist
  • Boone, IA
  • NPI 1881673267
  Medicare reassignment Care Compare group NPD
• Kyle Paul Anderson, O.D.

  • Optometrist
  • Fort Bliss, TX
  • NPI 1568821353

  IA

  Medicare reassignment Care Compare group NPD
• Jeffrey Craig Anderson, O.D.

  • Optometrist
  • Boone, IA
  • NPI 1760466098
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1131667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216857600000",
    "number": "1750362174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 STORY ST",
            "city": "BOONE",
            "state": "IA",
            "postal_code": "500362833",
            "telephone_number": "515-432-2973",
            "fax_number": "515-432-1811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 STORY ST",
            "city": "BOONE",
            "state": "IA",
            "postal_code": "500362833",
            "telephone_number": "515-432-2973",
            "fax_number": "515-432-1811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOONE VISION CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-11",
        "last_updated": "2008-07-24",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "CRAIG",
        "authorized_official_title_or_position": "OWNER OPTOMETRIST",
        "authorized_official_telephone_number": "515-432-2973",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "IA1854",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRM RAILROAD MEDICARE",
            "identifier": "CJ8678",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0480863",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Boone County Hospital Ambulance
• Boone County Recovery Center
• Boone County Transportation Service, Inc.
• Boone Family Dentistry
• Boone Vision Center
• Robert H Booth, DDS
• Mikel Jon Brandhorst, PHARM.D.
• Samantha Busch, MS, ATC, CES
• Connie J Buss, RD
• Genev J Calek, CRNA

• Optometrist in Boone, IA
• Providers in Boone, IA by specialty
• Optometrist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2008; 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.