NPIMap

Organization Active NPI

Madoptical

  • Eyewear Supplier
  • Council Bluffs, IA
National Provider Identifier
1992462188
Registry record updated Nov 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
MADOPTICAL
Practice address
1441 Mall Dr Ste 400
Council Bluffs, IA 51503-4728
Phone
(712) 256-5515
Fax
(712) 256-8093
NPI assigned
Nov 22, 2021
Last updated
Nov 22, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2021

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

Authorized official

Name
Mr. Mark Dickey, ABO, NCLENPI 1629981071
Title
Owner
Phone
(402) 639-3822

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

1441 Mall Dr Ste 400
Council Bluffs, IA 51503-4728

Mailing address

1441 Mall Dr Ste 400
Council Bluffs, IA 51503-4728
Phone (712) 256-5515

National Provider Directory

National Provider Directory

Locations

1441 Mall Dr
Ste 400
Council Bluffs, IA 51503
Phone (712) 256-5515

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.

NPI Registry JSON

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

{
    "created_epoch": "1637539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637539200000",
    "number": "1992462188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 MALL DR STE 400",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515034728",
            "telephone_number": "712-256-5515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 MALL DR STE 400",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515034728",
            "telephone_number": "712-256-5515",
            "fax_number": "712-256-8093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADOPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-22",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A",
        "authorized_official_last_name": "DICKEY",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-639-3822",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ABO, NCLE"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Council Bluffs, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2021; 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.