Organization Active NPI

Spencer Total Family Eyecare, P.C.

  • Optometrist
  • Spencer, IA
National Provider Identifier
1841603271
Registry record updated Nov 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
SPENCER TOTAL FAMILY EYECARE, P.C.
Practice address
110 W 4TH St
Spencer, IA 51301-3858
Phone
(712) 262-3331
Fax
(712) 262-6885
NPI assigned
Jun 3, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2014

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

Authorized official

Name
Dr. Amanda Ann Winterboer, O.D.NPI 1154634780
Title
Optometrist/ Owner
Phone
(712) 262-3331

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

110 W 4TH St
Spencer, IA 51301-3858

Mailing address

110 W 4TH St
PO Box 243
Spencer, IA 51301-3858
Phone (712) 262-3331

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141010000851 IA Part B Supplier - Clinic/Group Practice 2062632235 Receives reassigned benefits from 1 practitioner
Practice locations: Spencer, IA

National Provider Directory

National Provider Directory

Locations

110 W 4th St
Spencer, IA 51301
Phone (712) 262-3331

1104 W 18th St
Spencer, IA 51301
Phone (712) 262-3331

Practitioners & affiliated clinicians

Practitioners 2

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": "1401753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416268800000",
    "number": "1841603271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 W 4TH ST",
            "address_2": "PO BOX 243",
            "city": "SPENCER",
            "state": "IA",
            "postal_code": "513013858",
            "telephone_number": "712-262-3331",
            "fax_number": "712-262-6885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 W 4TH ST",
            "city": "SPENCER",
            "state": "IA",
            "postal_code": "513013858",
            "telephone_number": "712-262-3331",
            "fax_number": "712-262-6885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPENCER TOTAL FAMILY EYECARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-03",
        "last_updated": "2014-11-18",
        "status": "A",
        "authorized_official_last_name": "WINTERBOER",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OPTOMETRIST/ OWNER",
        "authorized_official_telephone_number": "712-262-3331",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spencer, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2014; 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.