Wahl Optical

Primary specialty

OptometristTaxonomy code 152W00000X

License

1511 Issued in IA

Legal business name

WAHL OPTICAL

Practice address

2201 W Broadway
Suite 2
Council Bluffs, IA 51501-3605

Phone

(712) 322-4554

Fax

(712) 322-2340

NPI assigned

Oct 10, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Robert Glen Wahl

Title

Owner

Phone

(712) 322-4554

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Dwayne F Sturtevant, OD

  • Optometrist
  • Omaha, NE
  • NPI 1972528560
  NPD (past)

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992893838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 W BROADWAY",
            "address_2": "SUITE 2",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515013605",
            "telephone_number": "712-322-4554",
            "fax_number": "712-322-2340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 W BROADWAY",
            "address_2": "SUITE 2",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515013605",
            "telephone_number": "712-322-4554",
            "fax_number": "712-322-2340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAHL OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WAHL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "GLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "712-322-4554",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IA",
            "license": "1511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0134080",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas Volberding, MD
• Douglas Vonderfecht, M.D.
• Mallori Jane Wagoner
• Misty D Wahab, ARNP
• Adnan Waheed
• Wal-Mart Stores, Inc
• Wal-Mart Stores, Inc.
• Walgreen Co
• Alex G Walker, M.D.
• Amy W Walker, R.D,

• Optometrist in Council Bluffs, IA
• Providers in Council Bluffs, IA by specialty
• Optometrist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.