NPIMap

Organization Active NPI

Woods Vision Care Specialists, Inc

  • Optometrist
  • Mascoutah, IL
National Provider Identifier
1851608186
Registry record updated Mar 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046006501 Issued in IL
Legal business name
WOODS VISION CARE SPECIALISTS, INC
Practice address
100 E Main St
Mascoutah, IL 62258-2135
Phone
(618) 566-8899
NPI assigned
Sep 8, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2011

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

Authorized official

Name
Dr. Marianne Wanda McDaniel, O.DNPI 1588793731
Title
Vice President
Phone
(618) 566-8899

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 046008579 IL
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 046006501 IL Primary

Addresses

Primary practice location

100 E Main St
Mascoutah, IL 62258-2135

Mailing address

100 E Main St
Mascoutah, IL 62258-2135
Phone (618) 566-8899

Other names 1

  • Mascoutah Eye Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110221000907 IL Part B Supplier - Clinic/Group Practice 1658552823 Receives reassigned benefits from 2 practitioners
Practice locations: Mascoutah, IL

National Provider Directory

National Provider Directory

Locations

105 Mascoutah Plaza Dr
Mascoutah, IL 62258
Phone (618) 566-8899

100 E Main St
Mascoutah, IL 62258
Phone (618) 566-8899

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": "1283904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299024000000",
    "number": "1851608186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E MAIN ST",
            "city": "MASCOUTAH",
            "state": "IL",
            "postal_code": "622582135",
            "telephone_number": "618-566-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E MAIN ST",
            "city": "MASCOUTAH",
            "state": "IL",
            "postal_code": "622582135",
            "telephone_number": "618-566-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODS VISION CARE SPECIALISTS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-08",
        "last_updated": "2011-03-02",
        "status": "A",
        "authorized_official_last_name": "MCDANIEL",
        "authorized_official_first_name": "MARIANNE",
        "authorized_official_middle_name": "WANDA",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "618-566-8899",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046008579",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046006501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mascoutah Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mascoutah, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2011; 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.