Vision Specialists of Council Bluffs LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

VISION SPECIALISTS OF COUNCIL BLUFFS LLC

Practice address

2514 W Broadway
Council Bluffs, IA 51501-3509

Phone

(712) 322-3097

Fax

(712) 322-4130

NPI assigned

Feb 8, 2008

Last updated

Jul 31, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kyle Cheatham, ODNPI 1568568384

Title

Owner

Phone

(712) 322-3097

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Locations

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kyle M Cheatham, O. D.

  • Optometrist
  • Council Bluffs, IA
  • NPI 1568568384
  Medicare reassignment Care Compare group Authorized official
• Jonathan Kingsley, OD

  • Optometrist
  • Council Bluffs, IA
  • NPI 1033891585
  Medicare reassignment Care Compare group NPD
• Katelyn Keefer, OD

  • Optometrist
  • Omaha, NE
  • NPI 1972125904

  IA

  Medicare reassignment Care Compare group NPD
• Jordan Frederick Keith, O.D.

  • Optometrist
  • Omaha, NE
  • NPI 1861646937

  IA

  Medicare reassignment Care Compare group NPD
• Trevor Aaron Schramm, OD

  • Optometrist
  • Hudsonville, MI
  • NPI 1033736400

  IA

  Medicare reassignment Care Compare group NPD
• Matthew Luke Willis, O.D.

  • Optometrist
  • Papillion, NE
  • NPI 1013204890

  IA

  Medicare reassignment Care Compare group NPD
• Eric James Ablott, OD

  • Optometrist
  • Randleman, NC
  • NPI 1356629026
  NPD (past)
• Brady Betten, O. D.

  • Optometrist
  • Omaha, NE
  • NPI 1467844779
  NPD (past)
• Shea Jewell Christensen, OD

  • Optometrist
  • Omaha, NE
  • NPI 1356506521
  NPD (past)
• Kelsey Jordan Daberkow, OD

  • Optometrist
  • Lincoln, NE
  • NPI 1609622885
  NPD (past)
• Madison Dembin, OD

  • Optometrist
  • Omaha, NE
  • NPI 1962274217
  NPD (past)
• Willie Ferguson, O.D.

  • Optometrist
  • Omaha, NE
  • NPI 1720216583
  NPD (past)

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

{
    "created_epoch": "1202428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532995200000",
    "number": "1831377084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2514 W BROADWAY",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515013509",
            "telephone_number": "712-322-3097",
            "fax_number": "712-322-4130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2514 W BROADWAY",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515013509",
            "telephone_number": "712-322-3097",
            "fax_number": "712-322-4130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISION SPECIALISTS OF COUNCIL BLUFFS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-08",
        "last_updated": "2018-07-31",
        "status": "A",
        "authorized_official_last_name": "CHEATHAM",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "712-322-3097",
        "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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• Visiting Nurse Services of Iowa (EveryStep)
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• Vocational Development Center Inc

• Optometrist in Council Bluffs, IA
• Providers in Council Bluffs, IA by specialty
• Optometrist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2018; 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.