Active NPI
Grene Vision Group LLC
- Optometrist
- Wichita, KS
National Provider Identifier
1972715696
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- Legal business name
- GRENE VISION GROUP LLC
- Practice address
- 8111 E Harry
Wichita, KS 67207 - Phone
- (316) 685-7661
- Fax
- (316) 685-0227
- NPI assigned
- May 4, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sheryl Davenport
- Title
- Insurance Department Supervisor
- Phone
- (316) 858-3831
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | Primary | ||
| Ophthalmology Physician | 207W00000X |
Addresses
Primary practice location
8111 E Harry
Wichita, KS 67207
Mailing address
1851 N Webb Rd
Attn FLR2
Wichita, KS 67206-3413
Phone (316) 636-2010
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KS
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040407000095 | KS | Part B Supplier - Clinic/Group Practice | 1254324023 |
Receives reassigned benefits from 45 practitioners 26 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Wellington, KS; Wichita, KS; Winfield, KS; Yates Center, KS; El Dorado, KS; Neodesha, KS; Lyons, KS; Hutchinson, KS… |
Other NPIs on the same Medicare enrollment 26
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178236800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1203465600000",
"number": "1972715696",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1851 N WEBB RD",
"address_2": "ATTN FLR2",
"city": "WICHITA",
"state": "KS",
"postal_code": "672063413",
"telephone_number": "316-636-2010",
"fax_number": "316-691-4408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8111 E HARRY",
"city": "WICHITA",
"state": "KS",
"postal_code": "67207",
"telephone_number": "316-685-7661",
"fax_number": "316-685-0227"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GRENE VISION GROUP LLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-05-04",
"last_updated": "2008-02-20",
"status": "A",
"authorized_official_last_name": "DAVENPORT",
"authorized_official_first_name": "SHERYL",
"authorized_official_title_or_position": "INSURANCE DEPARTMENT SUPERVISOR",
"authorized_official_telephone_number": "316-858-3831"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Optometrist",
"state": null,
"license": null,
"primary": true
},
{
"code": "207W00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Ophthalmology",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wichita, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2008; 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.