Eye Care Center of Waverly, PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

1865 Issued in IA

Legal business name

EYE CARE CENTER OF WAVERLY, PLLC

Practice address

108 2ND St NW
Waverly, IA 50677-2619

Phone

(319) 559-2020

Fax

(319) 559-2021

NPI assigned

Dec 27, 2016

Last updated

Dec 27, 2016By 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

Dr. Larry Howard Van Daalen, O.D.NPI 1366474355

Title

Optometrist

Phone

(310) 559-2020

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Practitioners 1

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.

• Larry H Vandaalen, OD

  • Optometrist
  • Waverly, IA
  • NPI 1366474355
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1482796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482796800000",
    "number": "1841735008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 2ND ST NW",
            "city": "WAVERLY",
            "state": "IA",
            "postal_code": "506772619",
            "telephone_number": "319-559-2020",
            "fax_number": "319-559-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 2ND ST NW",
            "city": "WAVERLY",
            "state": "IA",
            "postal_code": "506772619",
            "telephone_number": "319-559-2020",
            "fax_number": "319-559-2021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE CARE CENTER OF WAVERLY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-27",
        "last_updated": "2016-12-27",
        "status": "A",
        "authorized_official_last_name": "VAN DAALEN",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "HOWARD",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "310-559-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "1865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Brian Eggers, MD
• Angela Lynn Eisenman, LMHC
• Kaitlyn Ellerman, OTD, OTR/L
• Jenna Engel
• Emily Anne Evers, PT, DPT
• Lee O Fagre, MD
• Leah Renelle Fahlman, PHARMD
• Stephanie Faulkner
• Charity Fecht
• Michael Fettkether

• Optometrist in Waverly, IA
• Providers in Waverly, IA by specialty
• Optometrist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2016; 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.