ELMORE COUNTY EYECARE, PA. (NPI# 1003973736) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003973736 |
| Entity Type | Organization |
| Organization Name | ELMORE COUNTY EYECARE, PA. |
| Practice Address |
855 West 6th South Mountain Home ID 83647-3335 |
| Mailing Address |
855 W 6th S Mountain Home ID 83647-3335 |
| Practice Telephone | 2085872020 |
| Practice Fax Number | 2085873349 |
| Mailing Telephone | 2085872020 |
| Mailing Fax Number | 2085873349 |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2012-03-05 |
| Authorized Official Name | DR. NATHAN CURRAN PRICE (PRESIDENT) |
| Authorized Official Telephone | 2085872020 |
| Authorized Official Credential | O.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | ODP-995, ODP-966 | ID | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 1568427615 | 05 | |
| ID | 1003973736 | 05 | |
| ID | 1316038409 | 05 |
| Street Address |
855 WEST 6TH SOUTH |
| City | MOUNTAIN HOME |
| State | ID |
| Zip Code | 83647-3335 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750370730 | Kyle J Kenison | Optometrist | 855 West 6th South, Mountain Home, ID 83647 | 2005-10-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528684370 | The Unruly Tongue Myofunctional Therapy LLC | Specialist | 1125 Nw Bluegrass Cir, Mountain Home, ID 83647 | 2020-06-17 |
| 1740767284 | Kelly Loy | Counselor | 210 North 3rd East, Mountain Home, ID 83647 | 2018-07-27 |
| 1891247912 | Daelene Sueann Tibbitts | Physical Therapy Assistant | 1665 E 5th N, Mountain Home, ID 83647 | 2016-10-25 |
| 1689065765 | Emma Orthel | Counselor | 2240 American Legion Blvd, Mountain Home, ID 83647 | 2015-02-11 |
| 1073692166 | Krzysztof Hendryk Ziola | Internal Medicine | 2280 American Legion Blvd., Mountain Home, ID 83647 | 2006-11-02 |
| 1952482440 | Michael Peter Koelsch | Internal Medicine | 805 North 6th East, Mountain Home, ID 83647 | 2006-10-18 |
| 1124113709 | Talmage W Delange | Counselor | 235 North 3rd East, Mountain Home, ID 83647 | 2006-10-03 |
| 1225044019 | Scott W Sessions | Physical Therapist | 245 N. 3rd, Mountain Home, ID 83647 | 2006-07-31 |
| 1285628156 | Bruce Joseph Siedlecki | Obstetrics & Gynecology | Mtn.home Aif Force Base, Mdos, Mtn. Home, ID 83647 | 2005-09-07 |
| 1295728897 | Scott Alan Baldridge | Family Medicine | 365 Mckenna Dr, Mountain Home, ID 83647 | 2005-08-30 |
| Find all providers in zip 83647 | ||||
| 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 |
|---|---|---|---|---|
| 1255930160 | Maximillian Scott Crockett | Optometrist | James. H Quillen Vamc, Eye Clinic 112e, Mountain Home, TN 37684 | 2020-10-21 |
| 1508352287 | Leon Nguyen | Optometrist | James H. Quillen Vamc - Lamont St & Veterans Way, Eye Clinic 112e, Mountain Home, TN 37684 | 2018-07-06 |
| 1477926830 | Dara Auyeung | Optometrist | Eye Clinic 112e, Mountain Home, TN 37684-4000 | 2015-11-07 |
| 1538596671 | Dong Chan Suk | Optometrist | 99 Sidney St, Eye Clinic, Mountain Home, TN 37684 | 2013-10-03 |
| 1770713240 | Gary Michael Nadolsky | Optometrist | Corner of Lamont and Sydney Streets Building 200, Mountain Home, TN 37684 | 2009-07-19 |
| 1770748873 | Jonathan Paul Norris | Optometrist | 265 N 3rd E, Mountain Home, ID 83647-2734 | 2008-07-28 |
| 1801066360 | Hubert L. Cockrum Od Pa | Optometrist | 2183 Highway 62 W, Mountain Home, AR 72653-6500 | 2008-03-11 |
| 1487719423 | Langevin Vision Clinic | Optometrist | 115 South College Street, Mountain Home, AR 72653 | 2006-12-27 |
| 1841304391 | Dax Alan Gay | Optometrist | 809 Lamont Street, Mountain Home, TN 37684 | 2006-08-19 |
| 1700999448 | Nanette M Coelho | Optometrist | Building 8, Vamc Eye Clinic, Mountain Home, TN 37684 | 2006-08-16 |
| Find all providers in MOUNTAIN HOME | ||||
| City | MOUNTAIN HOME |
| Zip Code | 83647 |
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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.