NPIMap

Organization Active NPI

Proeye Group Shadow Lake, P.C.

  • Optometrist
  • Papillion, NE
National Provider Identifier
1972978435
Registry record updated Dec 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
944 Issued in NE
Legal business name
PROEYE GROUP SHADOW LAKE, P.C.
Practice address
7474 Towne Center Pkwy
Suite 107
Papillion, NE 68046-4805
Phone
(402) 592-3266
Fax
(402) 592-3249
NPI assigned
Dec 9, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2015

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

Authorized official

Name
Dr. William Jeffrey Geisert, O.D.
Title
Owner
Phone
(402) 730-4842

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 944 NE Primary

Addresses

Primary practice location

7474 Towne Center Pkwy
Suite 107
Papillion, NE 68046-4805

Mailing address

443 Road 4600
Hardy, NE 68943-8835

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1449619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449619200000",
    "number": "1972978435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "443 ROAD 4600",
            "city": "HARDY",
            "state": "NE",
            "postal_code": "689438835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7474 TOWNE CENTER PKWY",
            "address_2": "SUITE 107",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "680464805",
            "telephone_number": "402-592-3266",
            "fax_number": "402-592-3249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROEYE GROUP SHADOW LAKE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-09",
        "last_updated": "2015-12-09",
        "status": "A",
        "authorized_official_last_name": "GEISERT",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "JEFFREY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-730-4842",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NE",
            "license": "944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Papillion, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2015; 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.