Eyecare Centre

Primary specialty

OptometristTaxonomy code 152W00000X

License

02135 Issued in IA

Legal business name

EYECARE CENTRE

Practice address

3 E 18TH St
Spencer, IA 51301-3441

Phone

(712) 262-1589

Fax

(712) 262-3689

NPI assigned

Nov 1, 2006

Organization subpart

Yes

Parent organization

EYECARE CENTREAs reported in NPPES

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

Authorized official

Name

Samuel W. Butler, O.D.NPI 1538247135

Title

Optometrist

Phone

(712) 262-1589

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IA2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 2

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

• Eyecare Centre

  • Optometrist
  • Estherville, IA
  • NPI 1134339146

  1951295047

  Same PAC ID
• Eyecare Centre

  • Optometrist
  • Spirit Lake, IA
  • NPI 1750315040

  1951295047

  Same PAC ID

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Eyecare Centre

  • Optometrist
  • Estherville, IA
  • NPI 1134339146

  O20040210000768

  Same enrollment
• Eyecare Centre

  • Optometrist
  • Spirit Lake, IA
  • NPI 1750315040

  O20040210000768

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Stephen Rose OD3 organizations share this tax ID, including this one

Part of

Stephen Rose OD

Other organizations with this tax ID 2

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

• Eyecare Centre

  • Optometrist
  • Estherville, IA
  • NPI 1134339146
  NPD tax ID
• Eyecare Centre

  • Optometrist
  • Spirit Lake, IA
  • NPI 1750315040
  NPD tax ID

Locations

Practitioners 4

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

• Samuel W. Butler, O.D.

  • Optometrist
  • Spencer, IA
  • NPI 1538247135
  NPD Authorized official
• Randy Franklin Cornwall, OD

  • Optometrist
  • Spirit Lake, IA
  • NPI 1619901550
  NPD (past)
• Dawn M Webb, O.D.

  • Optometrist
  • Estherville, IA
  • NPI 1942343710
  NPD (past)
• Jacob Ray Jenness, OD

  • Optometrist
  • Bloomington, MN
  • NPI 1326787763
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198713600000",
    "number": "1780762229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 707",
            "city": "SPENCER",
            "state": "IA",
            "postal_code": "513010707",
            "telephone_number": "712-262-1589",
            "fax_number": "712-262-3689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 E 18TH ST",
            "city": "SPENCER",
            "state": "IA",
            "postal_code": "513013441",
            "telephone_number": "712-262-1589",
            "fax_number": "712-262-3689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYECARE CENTRE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EYECARE CENTRE",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-12-27",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "712-262-1589",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IA",
            "license": "02135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0198416",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "05577",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joshua John Espelund, M.D.
• Debra Ann Estes, LISW
• Kari Etherington, MPT, ATC
• Paige Elizabeth Evans Smith, NP-C
• Lindsey Marie Everett, RDLD
• Greta Ann Farley, RD
• Kasey Fear, CADC
• Bruce Anthony Feldmann, M.D.
• Lacey Marie Ferguson, PHARMD
• Todd Michael Fine, PHARMD.

• Optometrist in Spencer, IA
• Providers in Spencer, IA by specialty
• Optometrist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.