Organization Active NPI

Grinnell Eye Care PC

  • Optometrist
  • Grinnell, IA
National Provider Identifier
1770565749
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
GRINNELL EYE CARE PC
Practice address
208 West St
Grinnell, IA 50112-2014
Phone
(641) 236-4002
Fax
(641) 236-8687
NPI assigned
Nov 16, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Ramona D Mitchell, O.D.
Title
Vice President
Phone
(641) 236-4002

Specialties & licenses 1

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

Addresses

Primary practice location

208 West St
Grinnell, IA 50112-2014

Mailing address

PO Box 420
Grinnell, IA 50112-0420
Phone (641) 236-4002

Other identifiers 1

IdentifierTypeStateIssuer
0796748MedicaidIA

National Provider Directory

National Provider Directory

Locations

924 West St
Grinnell, IA 50112
Phone (563) 940-3778

Practitioners & affiliated clinicians

Practitioners 1

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": "1132099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1770565749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 420",
            "city": "GRINNELL",
            "state": "IA",
            "postal_code": "501120420",
            "telephone_number": "641-236-4002",
            "fax_number": "641-236-8687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 WEST ST",
            "city": "GRINNELL",
            "state": "IA",
            "postal_code": "501122014",
            "telephone_number": "641-236-4002",
            "fax_number": "641-236-8687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRINNELL EYE CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-16",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "RAMONA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "641-236-4002",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0796748",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grinnell, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.