Dr. Jeffrey L. Koenen, PC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

IA2072 Issued in IA

Legal business name

DR. JEFFREY L. KOENEN, PC

Doing business as

801 Eye Care Center

Practice address

801 Grand Ave Ste 350
Des Moines, IA 50309-8010

Phone

(515) 244-7393

Fax

(515) 244-2343

NPI assigned

Nov 4, 2008

Last updated

Nov 4, 2008By 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. Jeffrey L. Koenen, ODNPI 1295769644

Title

Optometrist/Owner

Phone

(515) 244-7393

Specialties & licenses 1

Addresses

Other names 1

• 801 Eye Care Center Doing business as

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Locations

Practitioners 2

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.

• Jeffrey Lynn Koenen, O.D.

  • Optometrist
  • Des Moines, IA
  • NPI 1295769644
  Medicare reassignment NPD Authorized official
• Sarah Koenen, LISW

  • Clinical Social Worker
  • West Des Moines, IA
  • NPI 1265087456

  Single Specialty

  NPD

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

{
    "created_epoch": "1225756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225756800000",
    "number": "1851545800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 GRAND AVE STE 350",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503098010",
            "telephone_number": "515-244-7393",
            "fax_number": "515-244-2343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 GRAND AVE STE 350",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503098010",
            "telephone_number": "515-244-7393",
            "fax_number": "515-244-2343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. JEFFREY L. KOENEN, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-04",
        "last_updated": "2008-11-04",
        "status": "A",
        "authorized_official_last_name": "KOENEN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "515-244-7393",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "IA",
            "license": "IA2072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "801 Eye Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinic/Center in Des Moines, IA
• Providers in Des Moines, IA by specialty
• Clinic/Center in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2008; 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.