Stewart Avenue Optical, Inc.

Primary specialty

Eye BankTaxonomy code 332G00000X

License

2629 Issued in WI

Legal business name

STEWART AVENUE OPTICAL, INC.

Practice address

2100 Stewart Ave Ste 120
Wausau, WI 54401-1707

Phone

(715) 845-1988

Fax

(715) 842-8793

NPI assigned

Mar 30, 2007

Organization subpart

No

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

Authorized official

Name

Nicole Lyons

Title

President

Phone

(715) 845-1988

Specialties & licenses 1

Addresses

Practitioners 2

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

• Robert Kessen, O.D.

  • Optometrist
  • Wausau, WI
  • NPI 1093777815
  NPD (past)
• Erica Kirk, OD

  • Optometrist
  • Wausau, WI
  • NPI 1760093843
  NPD (past)

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1780704049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 STEWART AVE STE 120",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544011707",
            "telephone_number": "715-845-1988",
            "fax_number": "715-842-8793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 STEWART AVE STE 120",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544011707",
            "telephone_number": "715-845-1988",
            "fax_number": "715-842-8793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEWART AVENUE OPTICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LYONS",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "715-845-1988"
    },
    "taxonomies": [
        {
            "code": "332G00000X",
            "taxonomy_group": "",
            "desc": "Eye Bank",
            "state": "WI",
            "license": "2629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Logan James Stern, DO
• Steven a. Benson PHD, LLC
• Judith Renee Stevenson, MA, LPC-T
• Lindsay Stevenson, MD
• Dawn M. Steves, MA, CCC-SLP
• Stewart Optical LLC
• John W. Stilp, D.D.S.
• Stephen B Stine, MD
• Rachel Mary Grace Stiver, LPN
• Daniel T. Stoehr, O.D.

• Eye Bank in Wausau, WI
• Providers in Wausau, WI by specialty
• Eye Bank in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.