NPIMap

Organization Active NPI

Eye Care Associates of Co, LLC

Doing business as Family Vision Center - Creston

  • Optometrist
  • Creston, IA
National Provider Identifier
1770346751
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
EYE CARE ASSOCIATES OF CO, LLC
Doing business as
Family Vision Center - Creston
Practice address
807 N Sumner Ave
Creston, IA 50801-1350
Phone
(641) 782-2111
NPI assigned
Feb 2, 2024
Last updated
Feb 2, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
EYE CARE ASSOCIATES OF CO, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

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

Authorized official

Name
David Deppen
Title
Senior Director, Revenue Cycle
Phone
(937) 539-8057

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

807 N Sumner Ave
Creston, IA 50801-1350

Mailing address

PO Box 879
Fort Washington, PA 19034-0879

Other names 1

  • Family Vision Center - Creston Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240520001305 IA DME Supplier - Physician - OptometristDME Supplier - Optician 9537597828 Practice locations: Creston, IA

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Eye Care Associates of Co LLC34 organizations share this tax ID, including this one
Part of
Eye Care Associates of Co LLC

Other organizations with this tax ID 33

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

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1706832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706832000000",
    "number": "1770346751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 879",
            "city": "FORT WASHINGTON",
            "state": "PA",
            "postal_code": "190340879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 N SUMNER AVE",
            "city": "CRESTON",
            "state": "IA",
            "postal_code": "508011350",
            "telephone_number": "641-782-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE CARE ASSOCIATES OF CO, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EYE CARE ASSOCIATES OF CO, LLC",
        "enumeration_date": "2024-02-02",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A",
        "authorized_official_last_name": "DEPPEN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "SENIOR DIRECTOR, REVENUE CYCLE",
        "authorized_official_telephone_number": "937-539-8057"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Vision Center - Creston",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Creston, IA

Sources for this page

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