NPIMap

Organization Active NPI

Wimmer P.a.

  • Optometrist
  • Pittsburg, KS
National Provider Identifier
1962517136
Registry record updated Oct 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1270-02 Issued in KS
Legal business name
WIMMER P.A.
Practice address
411 E Centennial Dr
Pittsburg, KS 66762-6505
Phone
(620) 232-1005
Fax
(620) 231-5821
NPI assigned
Aug 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2014

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

Authorized official

Name
Mr. Bradley R Wimmer, O.D.
Title
Owner/Doctor
Phone
(620) 232-1005

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1270-02 KS Primary

Addresses

Primary practice location

411 E Centennial Dr
Pittsburg, KS 66762-6505

Mailing address

411 E Centennial Dr
Pittsburg, KS 66762-6505
Phone (620) 232-1005

Other identifiers 1

IdentifierTypeStateIssuer
100219350BMedicaidKS

Other names 1

  • Wimmer Vision Care Other name

National Provider Directory

National Provider Directory

Locations

411 E Centennial Dr
Pittsburg, KS 66762
Phone (620) 232-1005

Practitioners & affiliated clinicians

Practitioners 5

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": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414540800000",
    "number": "1962517136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 E CENTENNIAL DR",
            "city": "PITTSBURG",
            "state": "KS",
            "postal_code": "667626505",
            "telephone_number": "620-232-1005",
            "fax_number": "620-231-5821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 E CENTENNIAL DR",
            "city": "PITTSBURG",
            "state": "KS",
            "postal_code": "667626505",
            "telephone_number": "620-232-1005",
            "fax_number": "620-231-5821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WIMMER P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2014-10-29",
        "status": "A",
        "authorized_official_last_name": "WIMMER",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "620-232-1005",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1270-02",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100219350B",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wimmer Vision Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Pittsburg, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2014; 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.