Owl Creek Vision Care

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

OWL CREEK VISION CARE

Practice address

278 Main St
Lander, WY 82520-3128

Phone

(307) 332-7284

Fax

(307) 332-7285

NPI assigned

Feb 21, 2007

Last updated

Mar 26, 2015By 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. David Wayne Rodgers, O.D.NPI 1942345277

Title

President

Phone

(307) 332-7284

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WY

Enrollment records 1

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.

• David Wayne Rodgers, O.D.

  • Optometrist
  • Lander, WY
  • NPI 1942345277
  Medicare reassignment NPD Authorized official
• John W Cary, O.D.

  • Optometrist
  • Lander, WY
  • NPI 1306874078
  Medicare reassignment NPD
• Jennifer Rae Rodgers, O.D.

  • Optometrist
  • Lander, WY
  • NPI 1689719866
  NPD (past)

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427328000000",
    "number": "1750426904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "278 MAIN ST",
            "city": "LANDER",
            "state": "WY",
            "postal_code": "825203128",
            "telephone_number": "307-332-7284",
            "fax_number": "307-332-7285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "278 MAIN ST",
            "city": "LANDER",
            "state": "WY",
            "postal_code": "825203128",
            "telephone_number": "307-332-7284",
            "fax_number": "307-332-7285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OWL CREEK VISION CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2015-03-26",
        "status": "A",
        "authorized_official_last_name": "RODGERS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "307-332-7284",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF WY PRACTICE",
            "identifier": "4721001",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124197400",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Baylee Carlene Olson, PA-C
• Tyler Michael Olson
• Regina Ommen
• Osback Pharmaceuticals Inc (Palace Pharmacy)
• Neil Otto
• Courtney Hanna Page
• Pain Care Center LLC
• Peter J Pappas, DMD
• Christine Sialia Parr, B.S. IN ED.
• Path Behavioral Health Wyoming LLC

• Clinic/Center in Lander, WY
• Providers in Lander, WY by specialty
• Clinic/Center in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2015; 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.