Medical Arts Eyecare, PLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

01536 Issued in IA

Legal business name

MEDICAL ARTS EYECARE, PLC

Practice address

1428 2ND Ave N
Fort Dodge, IA 50501-4119

Phone

(515) 573-1145

Fax

(515) 573-1028

NPI assigned

Dec 4, 2006

Organization subpart

No

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

Authorized official

Name

Jody M Shanks

Title

Office Manager

Phone

(515) 573-1145

Specialties & licenses 1

Addresses

Other identifiers 9

Tax ID family

Medical Arts Eyecare PLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• R. Y. Jacobson, OD

  • Optometrist
  • Fort Dodge, IA
  • NPI 1700022084
  NPD tax ID

Locations

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438041600000",
    "number": "1912065095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1428 2ND AVE N",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505014119",
            "telephone_number": "515-573-1145",
            "fax_number": "515-573-1028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1428 2ND AVE N",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505014119",
            "telephone_number": "515-573-1145",
            "fax_number": "515-573-1028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL ARTS EYECARE, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2015-07-28",
        "status": "A",
        "authorized_official_last_name": "SHANKS",
        "authorized_official_first_name": "JODY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "515-573-1145"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IA",
            "license": "01536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RY JACOBSON, O.D BCBS",
            "identifier": "07134",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3066183",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000389",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LENANE, O.D. BCBS",
            "identifier": "38024",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID - TYPE UNSPECIFIED",
            "identifier": "IB1233002",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "IB1233003",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5145540",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID - TYPE UNSPECIFIED",
            "identifier": "IB1233",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID - TYPE UNSPECIFIED",
            "identifier": "IB1233001",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jack A McEvoy
• Anissa McGee, OTD, OTR/L
• Hannah McLimans
• Barb McNeil, BA
• Gatlin Dell Meador, PA
• Medical Imaging & Radiology Associates, LLP
• Eileen Meier, PMHNP-BC
• Alicia Deane Meldrem, CADC
• Lizeth Merino Martinez
• Brad Anthony Messerly, D.C.

• Optometrist in Fort Dodge, IA
• Providers in Fort Dodge, IA by specialty
• Optometrist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.