Organization Active NPI

Western Medical Eye Center, LLC

  • Specialist
  • Bullhead City, AZ
National Provider Identifier
1760664825
Registry record updated Dec 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
WESTERN MEDICAL EYE CENTER, LLC
Practice address
1800 Highway 95
Bullhead City, AZ 86442-6803
Phone
(928) 763-4333
NPI assigned
Nov 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2010

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

Authorized official

Name
Mrs. Susan N Glesmann
Title
Vice President
Phone
(928) 763-8443

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

1800 Highway 95
Bullhead City, AZ 86442-6803

Mailing address

1800 Highway 95
Bullhead City, AZ 86442-6803
Phone (928) 763-4333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071102000221 AZ Part B Supplier - Clinic/Group Practice 4284721549 Receives reassigned benefits from 3 practitioners
Practice locations: Bullhead City, AZ; Kingman, AZ

National Provider Directory

National Provider Directory

Locations

1800 Highway 95
#2
Bullhead City, AZ 86442

3953 N Stockton Hill Rd
Kingman, AZ 86409
Phone (928) 757-3330

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1196380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291248000000",
    "number": "1760664825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 HIGHWAY 95",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864426803",
            "telephone_number": "928-763-4333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 HIGHWAY 95",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864426803",
            "telephone_number": "928-763-4333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN MEDICAL EYE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-30",
        "last_updated": "2010-12-02",
        "status": "A",
        "authorized_official_last_name": "GLESMANN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "928-763-8443",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bullhead City, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2010; 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.