NPIMap

Individual provider Active NPI

John C Metzger, OD

  • Vision Therapy Optometrist
  • Overland Park, KS
National Provider Identifier
1821066903
Registry record updated Feb 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vision Therapy OptometristTaxonomy code 152WV0400X
License
1105 Issued in KS
Practice address
10875 Grandview Drive
Suite 2260
Overland Park, KS 66210-1571
Phone
(913) 469-8686
Fax
(913) 469-8688
NPI assigned
Mar 14, 2006
Last updated
Feb 23, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 829 NE
Optometrist 152W00000X 1105 KS
Low Vision Rehabilitation Optometrist 152WL0500X 1105 KS
Vision Therapy Optometrist 152WV0400X 1105 KS Primary

Addresses

Primary practice location

10875 Grandview Drive
Suite 2260
Overland Park, KS 66210-1571

Mailing address

10875 Grandview Drive
Suite 2260
Overland Park, KS 66210-1571
Phone (913) 469-8686

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070904000520 MO Practitioner - Optometry 3971495276 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11052KSMDPharmacist
829NEMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Zona Rosa Eyecare Inc Optometrist CurrentSince Jun 1, 2012 Accepting new patients
Professional Eyecare Zona Rosa Inc. Optometrist Past Accepting new patients
Professional Eyecare - Fountains Inc Optometrist Past Accepting new patients
Professional Eyecare Metro North Inc Optometrist Past Accepting new patients
Oculi Vision Rehabilitation, LLC Optometrist Past Accepting new patients
Eye Specialists of Atchison, LLC Past Accepting new patients

Locations

6575 W 119th St
Overland Park, KS 66209
Phone (913) 696-0092

8403 N Mercier St
Kansas City, MO 64155
Phone (816) 468-1220

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424649600000",
    "number": "1821066903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10875 GRANDVIEW DRIVE",
            "address_2": "SUITE 2260",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662101571",
            "telephone_number": "913-469-8686",
            "fax_number": "913-469-8688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10875 GRANDVIEW DRIVE",
            "address_2": "SUITE 2260",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662101571",
            "telephone_number": "913-469-8686",
            "fax_number": "913-469-8688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METZGER",
        "first_name": "JOHN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2015-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NE",
            "license": "829",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1105",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "KS",
            "license": "1105",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "KS",
            "license": "1105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.