Havera Eye Care Specialists LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

HAVERA EYE CARE SPECIALISTS LLC

Practice address

119 N Morrison Ave
Collinsville, IL 62234-3226

Phone

(618) 344-0511

Fax

(618) 344-0545

NPI assigned

Jul 8, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Mark A Havera, O.D.NPI 1306125166

Title

Optometrist

Phone

(618) 344-0511

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark A Havera, OD

  • Optometrist
  • Edwardsville, IL
  • NPI 1306125166
  Medicare reassignment Care Compare group NPD Authorized official
• Jeffrey P. Herberts, O.D.

  • Optometrist
  • Collinsville, IL
  • NPI 1528153509
  Medicare reassignment Care Compare group NPD
• David Junge

  • Optometrist
  • Granite City, IL
  • NPI 1942938626
  Medicare reassignment NPD
• Mark A Kleindorfer, O.D.

  • Optometrist
  • Granite City, IL
  • NPI 1992762413
  NPD (past)

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

{
    "created_epoch": "1562544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562544000000",
    "number": "1942862214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 FIELDSTONE DR",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620626436",
            "telephone_number": "217-259-9023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 N MORRISON AVE",
            "city": "COLLINSVILLE",
            "state": "IL",
            "postal_code": "622343226",
            "telephone_number": "618-344-0511",
            "fax_number": "618-344-0545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVERA EYE CARE SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-08",
        "last_updated": "2019-07-08",
        "status": "A",
        "authorized_official_last_name": "HAVERA",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "618-344-0511",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Nolte Hahn, D.M.D
• Shannon Noelle Hall-Nannini, MSW, LSW
• Amy Hargett, M.S., CCC-SLP
• Cal W Harmon, DMD
• Dawn Marie Harris, PT
• Health Ventures of Southern Illinois LLC
• Amanda Hemphill, FNP-BC
• Julie B. Hendricks, O.D.
• Ronald Wayne Henson, LCPC, MA CMHC
• Jeffrey P. Herberts, O.D.

• Optometrist in Collinsville, IL
• Providers in Collinsville, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2019; 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.