GRACIE CHASE AVERY, LLC (NPI# 1003320607) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003320607 |
| Entity Type | Organization |
| Organization Name | GRACIE CHASE AVERY, LLC |
| Other Organization Name | 4STATES VISION EXPRESS |
| Practice Address |
1701 W 26th St Ste E Joplin MO 64804-1513 |
| Practice Telephone | 4179252366 |
| Practice Fax Number | 4179252367 |
| Mailing Telephone | 4179252366 |
| Mailing Fax Number | 4179252367 |
| Enumeration Date | 2017-11-20 |
| Last Update Date | 2020-10-16 |
| Authorized Official Name | DR. KEVIN MICHAEL GARDNER (OWNER) |
| Authorized Official Telephone | 4174997715 |
| Authorized Official Credential | OD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | T03487 | MO | Eye and Vision Services Providers |
| Other Name | Type Code |
|---|---|
| 4States Vision Express | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5265 South Business 71, Suite B3, Pineville, MO 64856 | 4172233937 | 4172233938 |
| Street Address |
1701 W 26TH ST STE E |
| City | JOPLIN |
| State | MO |
| Zip Code | 64804-1513 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033718903 | Lisa Jo Moore | Nurse Practitioner | 2623 S Main Street, Nixa, MO 64804 | 2020-10-22 |
| 1346859600 | Centered and Connected LLC | Counselor | 2401 E 32nd St, Ste 10 #103, Joplin, MO 64804 | 2020-07-23 |
| 1649838780 | Nicole Lynn Egan | Social Worker | 3010 Mcclelland, Joplin, MO 64804 | 2019-06-04 |
| 1902361652 | Redings Mill Internal Care | Clinic/Center | 454 Redings Mill Rd, Joplin, MO 64804 | 2019-02-06 |
| 1447732508 | Urgent Care Travel, Inc | Clinic/Center | 5931 E 32nd Street, Joplin, MO 64804 | 2018-09-05 |
| 1912488891 | Karl G. Keczkemethy | Dietitian, Registered | 100 Mercy Way Ste 570, Joplin, MO 64804 | 2018-08-28 |
| 1790207546 | Jacksie Short | Dentist | 2819 E 29th St, Joplin, MO 64804 | 2017-07-13 |
| 1326574625 | Kristine Kwon Rowland | Nurse Practitioner | 100 Mercy Way Ste 320-330, Joplin, MO 64804 | 2017-05-05 |
| 1942735212 | West R Loveland | Counselor | 3230 S Wisconsin St Suite H, Joplin, MO 64804 | 2017-04-25 |
| 1174070205 | Tracy L Fry | Nurse Practitioner | 3333 Mcintosh Cir Ste 4, Joplin, MO 64804 | 2016-09-07 |
| Find all providers in zip 64804 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649426313 | Dr. Susan M. Haas, PC | Optometrist | 1816 S Michigan Ave, Joplin, MO 64804-0948 | 2008-08-13 |
| 1275707887 | Advance Eyecare Associates LLC | Optometrist | 5832 N Main St, Joplin, MO 64801-9611 | 2008-04-15 |
| 1134313935 | George T Meade | Optometrist | 11216 Birch Drive, Joplin, MO 64804 | 2007-09-05 |
| 1902000466 | Stilley Eye Associates, P.C. | Optometrist | 1602 S Range Line Rd, Joplin, MO 64804-3231 | 2007-06-11 |
| 1205048170 | Lazenby Optometry Associates Inc | Optometrist | 2318 E. 32nd St., Suite A, Joplin, MO 64804-4326 | 2007-05-04 |
| 1326101346 | Pamela K Warbinton | Optometrist | 701 S Range Line Rd, Joplin, MO 64801-5582 | 2006-12-19 |
| 1235224676 | Rebecca J. Stilley | Optometrist | 1602 S. Rangeline Rd., Joplin, MO 64804 | 2006-10-03 |
| 1750489001 | Lorry Wayne Lazenby | Optometrist | 2318 E 32nd St Ste A, Joplin, MO 64804-4326 | 2006-09-20 |
| 1346358769 | Kevin M Gardner | Optometrist | 1531 W 32nd Street, Suite 102, Joplin, MO 64804-1651 | 2006-08-27 |
| 1417060153 | Susan Marie Haas | Optometrist | 2623 West 7th Street, Joplin, MO 64801 | 2006-08-16 |
| Find all providers in JOPLIN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.