Organization Active NPI

O'Bryan Eyecare, P.C.

  • Optometrist
  • Saint Joseph, MO
National Provider Identifier
1922334382
Registry record updated Oct 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
O'BRYAN EYECARE, P.C.
Practice address
3120 Karnes Rd
Suite a
Saint Joseph, MO 64506-1319
Phone
(816) 364-5800
Fax
(816) 364-5806
NPI assigned
Oct 20, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2009

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

Authorized official

Name
Dr. Gregory D. O'Bryan, O.D.NPI 1609931260
Title
President/Owner
Phone
(816) 364-5800

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

3120 Karnes Rd
Suite a
Saint Joseph, MO 64506-1319

Mailing address

3120 Karnes Rd
Suite a
Saint Joseph, MO 64506-1319
Phone (816) 364-5800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091118000014 MO Part B Supplier - Clinic/Group Practice 1658274170 Receives reassigned benefits from 1 practitioner
Practice locations: Maryville, MO; Saint Joseph, MO

National Provider Directory

National Provider Directory

Locations

1713 S Main St
Maryville, MO 64468
Phone (660) 582-8911

3120 Karnes Rd
Ste A
Saint Joseph, MO 64506
Phone (816) 364-5800

Practitioners & affiliated clinicians

Practitioners 1

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": "1255996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256083200000",
    "number": "1922334382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3120 KARNES RD",
            "address_2": "SUITE A",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645061319",
            "telephone_number": "816-364-5800",
            "fax_number": "816-364-5806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3120 KARNES RD",
            "address_2": "SUITE A",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645061319",
            "telephone_number": "816-364-5800",
            "fax_number": "816-364-5806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "O'BRYAN EYECARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-20",
        "last_updated": "2009-10-21",
        "status": "A",
        "authorized_official_last_name": "O'BRYAN",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "816-364-5800",
        "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 Saint Joseph, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2009; 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.