Organization Active NPI

Senior Vision Services of Kansas

  • Optometrist
  • Omaha, NE
National Provider Identifier
1972553071
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1539 Issued in KS
Legal business name
SENIOR VISION SERVICES OF KANSAS
Practice address
9239 W Center Rd
Omaha, NE 68124-1900
Phone
(402) 898-3232
Fax
(402) 898-3234
NPI assigned
May 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Lyndon Graves, O.D.NPI 1205886736
Title
Owner
Phone
(402) 898-3232

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 1539 KS Primary

Addresses

Primary practice location

9239 W Center Rd
Omaha, NE 68124-1900

Mailing address

PO Box 30128
Omaha, NE 68103-1228
Phone (402) 898-3232

Other identifiers 1

IdentifierTypeStateIssuer
DB5426MedicaidKS

National Provider Directory

National Provider Directory

Locations

1830 S Broadway St
Leavenworth, KS 66048
Phone (816) 223-1374

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": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972553071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30128",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681031228",
            "telephone_number": "402-898-3232",
            "fax_number": "402-898-3234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9239 W CENTER RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681241900",
            "telephone_number": "402-898-3232",
            "fax_number": "402-898-3234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIOR VISION SERVICES OF KANSAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GRAVES",
        "authorized_official_first_name": "LYNDON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-898-3232",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DB5426",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.