NPIMap

Organization Active NPI

Optometric Associates of Warren County PC

  • Optometrist
  • Norwalk, IA
National Provider Identifier
1962453779
Registry record updated Feb 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
OPTOMETRIC ASSOCIATES OF WARREN COUNTY PC
Practice address
1228 Sunset Dr
Ste a
Norwalk, IA 50211-2401
Phone
(515) 981-0224
Fax
(515) 981-5389
NPI assigned
May 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2014

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

Authorized official

Name
Craig A Winjum, ODNPI 1457319063
Title
President
Phone
(515) 961-5305

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

1228 Sunset Dr
Ste a
Norwalk, IA 50211-2401

Mailing address

1228 Sunset Dr
Ste a
Norwalk, IA 50211-2401
Phone (515) 981-0224

Other identifiers 1

IdentifierTypeStateIssuer
0118950MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040305000556 IA Part B Supplier - Clinic/Group Practice 2567350226 Receives reassigned benefits from 3 practitioners
2 other NPIs on this enrollment
Practice locations: Carlisle, IA; Indianola, IA; Norwalk, IA
O20100930001041 IA DME Supplier - Physician - Optometrist 2567350226 Practice locations: Norwalk, IA

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Optometric Associates of Warren Cty1228 Sunset Dr, Norwalk, IA 50211-2401(515) 981-0224 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Oct 1, 1984

National Provider Directory

National Provider Directory

Locations

225 W Ashland Ave
Ste 1
Indianola, IA 50125
Phone (515) 961-5305

1228 Sunset Dr
Ste A
Norwalk, IA 50211
Phone (515) 981-0224

Practitioners & affiliated clinicians

Practitioners 6

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": "1147651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391472000000",
    "number": "1962453779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1228 SUNSET DR",
            "address_2": "STE A",
            "city": "NORWALK",
            "state": "IA",
            "postal_code": "502112401",
            "telephone_number": "515-981-0224",
            "fax_number": "515-981-5389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1228 SUNSET DR",
            "address_2": "STE A",
            "city": "NORWALK",
            "state": "IA",
            "postal_code": "502112401",
            "telephone_number": "515-981-0224",
            "fax_number": "515-981-5389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTOMETRIC ASSOCIATES OF WARREN COUNTY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-15",
        "last_updated": "2014-02-04",
        "status": "A",
        "authorized_official_last_name": "WINJUM",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "515-961-5305",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0118950",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.