Active NPI
Spectacle Shop LLC
- Eyewear Supplier
- Hartington, NE
National Provider Identifier
1982309571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Eyewear Supplier
- Legal business name
- SPECTACLE SHOP LLC
- Practice address
- 202 S Robinson Ave
Hartington, NE 68739-5501 - Phone
- (402) 254-2020
- Fax
- (402) 254-7122
- NPI assigned
- Apr 3, 2023
- Last updated
- Sep 19, 2023
- 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
- Hailey Lynn Schelling
- Title
- Practice Manager
- Phone
- (605) 665-9638
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Eyewear Supplier | 332H00000X | Primary |
Addresses
Primary practice location
202 S Robinson Ave
Hartington, NE 68739-5501
Mailing address
415 W 3Rd St
Yankton, SD 57078-4201
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240517001973 | NE | DME Supplier - Physician - Ophthalmology | 4486971918 | Practice locations: Hartington, NE |
Other NPIs with the same Medicare PAC ID 2
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
National Provider Directory
National Provider Directory- Tax ID family
- Spectacle Shop LLC
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Eyewear Supplier
- Creighton, NE
- NPI 1730884321
-
- Eyewear Supplier
- Yankton, SD
- NPI 1992792600
Locations
415 W 3rd St
Yankton, SD 57078
Phone (605) 665-0938
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Optometrist
- Yankton, SD
- NPI 1336142272
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1680480000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1695081600000",
"number": "1982309571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "415 W 3RD ST",
"city": "YANKTON",
"state": "SD",
"postal_code": "570784201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "202 S ROBINSON AVE",
"city": "HARTINGTON",
"state": "NE",
"postal_code": "687395501",
"telephone_number": "402-254-2020",
"fax_number": "402-254-7122"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SPECTACLE SHOP LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-04-03",
"last_updated": "2023-09-19",
"certification_date": "2023-09-19",
"status": "A",
"authorized_official_last_name": "SCHELLING",
"authorized_official_first_name": "HAILEY",
"authorized_official_middle_name": "LYNN",
"authorized_official_title_or_position": "PRACTICE MANAGER",
"authorized_official_telephone_number": "605-665-9638"
},
"taxonomies": [
{
"code": "332H00000X",
"taxonomy_group": "",
"desc": "Eyewear Supplier",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hartington, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; 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.