Spooner Eye Care SC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

SPOONER EYE CARE SC

Practice address

1611 River St
Payette, ID 83661-2073

Phone

(715) 520-3414

NPI assigned

Mar 8, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Sondra Kay Shellito

Title

Office Manager

Phone

(715) 520-3606

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Spooner Eye Care Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Seebruck, OD

  • Optometrist
  • Rice Lake, WI
  • NPI 1497283493
  NPD (past)
• Gabrielle Carmen Chan Smiley, OD

  • Optometrist
  • Rice Lake, WI
  • NPI 1326576323
  NPD (past)

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575936000000",
    "number": "1992773998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 RIVER ST",
            "city": "PAYETTE",
            "state": "ID",
            "postal_code": "836612073",
            "telephone_number": "715-520-3414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 RIVER ST",
            "city": "PAYETTE",
            "state": "ID",
            "postal_code": "836612073",
            "telephone_number": "715-520-3414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPOONER EYE CARE SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-08",
        "last_updated": "2019-12-10",
        "certification_date": "2019-12-10",
        "status": "A",
        "authorized_official_last_name": "SHELLITO",
        "authorized_official_first_name": "SONDRA",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "715-520-3606",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "2200142",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38723400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spooner Eye Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Spooner Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cristy Lynn Schroeder, LMSW
• Michael Seward
• Andrew Silsby, FNP-C
• Justin Craig Smith, DMD
• Snake River Dental Inc.
• Carolyn Anderson St. Germain, LCSW
• Jordan Alexis St. Martin
• Phillip E Stevenson, PA-C
• Marcia Strahn, CNM
• Anthony Leon Strasser, D.C.

• Optometrist in Payette, ID
• Providers in Payette, ID by specialty
• Optometrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2019; 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.