Great Rivers Eye Care

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

GREAT RIVERS EYE CARE

Practice address

519 S State St
Jerseyville, IL 62052-2241

Phone

(217) 342-2672

NPI assigned

Dec 13, 2022

Organization subpart

No

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

Authorized official

Name

Ms. Michelle A Smith

Title

Director of Operations

Phone

(217) 342-2672

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 2

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

• Amanda Gerson

  • Optometrist
  • Jerseyville, IL
  • NPI 1417514134
  Medicare reassignment NPD
• Matthew Robert Jones, OD

  • Optometrist
  • Effingham, IL
  • NPI 1578727368
  NPD (past)

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

{
    "created_epoch": "1670889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728432000000",
    "number": "1770294449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 N KELLER DR",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624011859",
            "telephone_number": "217-342-2672",
            "fax_number": "217-342-2681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 S STATE ST",
            "city": "JERSEYVILLE",
            "state": "IL",
            "postal_code": "620522241",
            "telephone_number": "217-342-2672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT RIVERS EYE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-13",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "217-342-2672",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• German Insurance Agency
• Amanda Gerson
• David J Goetten, D.M.D.
• Edward Eugene Goetten, D.O
• Marianne C. Golike, LCPC
• Katelyn Elizabeth Green
• Greenwood Manor Nursing Home Inc
• Lindsay Grififn, BEHAVIOR TECHNICIAN
• John Michael Guercio, PHD BCBA-D CBIST
• Carla R Hagen

• Optometrist in Jerseyville, IL
• Providers in Jerseyville, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; 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.