NPIMap

Organization Active NPI

Physicians Eyewear, L.L.C.

  • Eyewear Supplier
  • Grand Island, NE
National Provider Identifier
1790788677
Registry record updated Apr 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
PHYSICIANS EYEWEAR, L.L.C.
Practice address
711 N Custer Ave
Ste 2
Grand Island, NE 68803-4311
Phone
(308) 382-7223
Fax
(308) 382-6299
NPI assigned
May 24, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2011

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

Authorized official

Name
Dr. Robert S. Proffitt, M.D.NPI 1972506871
Title
Owner
Phone
(308) 382-7223

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

711 N Custer Ave
Ste 2
Grand Island, NE 68803-4311

Mailing address

711 N Custer Ave
Ste 2
Grand Island, NE 68803-4311
Phone (308) 382-7223

Other identifiers 1

IdentifierTypeStateIssuer
100249654-00MedicaidNE

National Provider Directory

National Provider Directory

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": "1116892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303344000000",
    "number": "1790788677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 N CUSTER AVE",
            "address_2": "STE 2",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688034311",
            "telephone_number": "308-382-7223",
            "fax_number": "308-382-6299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 N CUSTER AVE",
            "address_2": "STE 2",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688034311",
            "telephone_number": "308-382-7223",
            "fax_number": "308-382-6299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS EYEWEAR, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-24",
        "last_updated": "2011-04-21",
        "status": "A",
        "authorized_official_last_name": "PROFFITT",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "308-382-7223",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100249654-00",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Island, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2011; 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.