Eyes on Main, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

EYES ON MAIN, LLC

Practice address

223 E. Main St
Festus, MO 63028-1952

Phone

(636) 937-2399

NPI assigned

Jun 26, 2021

Organization subpart

No

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

Authorized official

Name

Deanne Wolk, ODNPI 1922236678

Title

Optometrist

Phone

(636) 937-2399

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Practitioners 4

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

• Deanne Michelle Wolk, O.D.

  • Optometrist
  • Festus, MO
  • NPI 1922236678
  Medicare reassignment NPD Authorized official
• Laura Ann Bequette, O.D., OTR/L

  • Optometrist
  • Festus, MO
  • NPI 1972730091
  Medicare reassignment NPD
• David L Green, OD

  • Optometrist
  • Saint Louis, MO
  • NPI 1821180670
  NPD (past)
• Peter H Zimmerman, OD

  • Optometrist
  • Festus, MO
  • NPI 1841285061
  NPD (past)

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

{
    "created_epoch": "1624665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638403200000",
    "number": "1811567431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 MAIN ST",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630281952",
            "telephone_number": "636-937-2399",
            "fax_number": "636-937-4683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 E. MAIN ST",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630281952",
            "telephone_number": "636-937-2399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYES ON MAIN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-26",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A",
        "authorized_official_last_name": "WOLK",
        "authorized_official_first_name": "DEANNE",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "636-937-2399",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Festus, MO
• Providers in Festus, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2021; 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.