Organization Active NPI

Signature Eye Care, P.C.

  • Optometrist
  • Lincoln, NE
National Provider Identifier
1962692160
Registry record updated Apr 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1147 Issued in NE
Legal business name
SIGNATURE EYE CARE, P.C.
Practice address
5630 S 84TH St
Suite 120
Lincoln, NE 68516-4470
Phone
(402) 488-2211
NPI assigned
Jul 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2008

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

Authorized official

Name
Dr. Jonathan Glyndon Knutson, O.D.NPI 1003800012
Title
Owner
Phone
(402) 488-2211

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 1147 NE Primary

Addresses

Primary practice location

5630 S 84TH St
Suite 120
Lincoln, NE 68516-4470

Mailing address

5630 S 84TH St
Suite 120
Lincoln, NE 68516-4470
Phone (402) 488-2211

Other identifiers 1

IdentifierTypeStateIssuer
10025538200MedicaidNE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070803000554 NE Part B Supplier - Clinic/Group Practice 5496846545 Receives reassigned benefits from 1 practitioner
Practice locations: Lincoln, NE

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.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
28D2057645Signature Eye Care PC5630 S 84TH Street, Suite 120, Lincoln, NE 68516Certificate of waiverFeb 4, 2027

National Provider Directory

National Provider Directory

Locations

5630 S 84th St
Ste 120
Lincoln, NE 68516
Phone (402) 488-2211

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": "1185321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207526400000",
    "number": "1962692160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5630 S 84TH ST",
            "address_2": "SUITE 120",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685164470",
            "telephone_number": "402-488-2211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5630 S 84TH ST",
            "address_2": "SUITE 120",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685164470",
            "telephone_number": "402-488-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIGNATURE EYE CARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-25",
        "last_updated": "2008-04-07",
        "status": "A",
        "authorized_official_last_name": "KNUTSON",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "GLYNDON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-488-2211",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NE",
            "license": "1147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025538200",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2008; 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.