BODENHAMER EYE CONSULTANTS, LLC (NPI# 1679903330) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679903330 |
| Entity Type | Organization |
| Organization Name | BODENHAMER EYE CONSULTANTS, LLC |
| Practice Address |
3238 W Truman Blvd Upper Level Jefferson City MO 65109-5708 |
| Practice Telephone | 5736352020 |
| Practice Fax Number | 5736357840 |
| Mailing Telephone | 5736352020 |
| Mailing Fax Number | 5736357840 |
| Enumeration Date | 2013-11-17 |
| Last Update Date | 2017-01-16 |
| Authorized Official Name | BRET B BODENHAMER (PROVIDER) |
| Authorized Official Telephone | 5736352020 |
| Authorized Official Credential | OD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152WC0802X |
Optometrist Specialization: Corneal and Contact Management |
2010026679 | MO | Eye and Vision Services Providers |
| N | 152WP0200X |
Optometrist Specialization: Pediatrics |
2007018327 | MO | Eye and Vision Services Providers |
| Y | 152WC0802X |
Optometrist Specialization: Corneal and Contact Management |
TO2261 | MO | Eye and Vision Services Providers |
| Street Address |
3238 W TRUMAN BLVD UPPER LEVEL |
| City | JEFFERSON CITY |
| State | MO |
| Zip Code | 65109-5708 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679887384 | Bret Allen Bodenhamer | Optometrist | 3238 W Truman Blvd, Jefferson City, MO 65109-5708 | 2010-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518449321 | Kara D Roderick | Physical Therapist | 1115 Fairgrounds Road, Jefferson City, MO 65109 | 2018-08-29 |
| 1851871214 | Integrative Medicine, LLC | Internal Medicine | 999 Diamond Rdg Ste 201, Jefferson City, MO 65109 | 2018-08-15 |
| 1972020394 | Rehab Care Group East, LLC | Clinic/Center | Primrose Retirement Community Jefferson City, 1214 Freedom Boulevard, Jefferson City, MO 65109 | 2017-08-25 |
| 1124558986 | Nicholas Rehagen | Specialist/Technologist | 304 Timber Creek Rd, Jefferson City, MO 65109 | 2017-06-14 |
| 1982004214 | Kara Elizabeth Wilbers | Occupational Therapist | 1105 Fairgrounds Rd, Jefferson City, MO 65109 | 2014-08-22 |
| 1942510334 | Loftin Eyecare, LLC | Optometrist | 724 West Stadium Boulevard, # 029 Walmart Vision Center, Jefferson City, MO 65109 | 2010-10-19 |
| 1306077250 | Paula Hancock Johnson | Social Worker | 1303 Edgewood Dr Ste 5, Jefferson City, MO 65109 | 2009-07-27 |
| 1679701296 | Capital Region Medical Center | Family Medicine | 3308 W Edgewood, Suite B, Jefferson City, MO 65109 | 2009-06-23 |
| 1972730141 | Nancy S Stork | Counselor | 204 Metro, Suite B, Jefferson City, MO 65109 | 2009-06-16 |
| 1356522916 | Walk Easy LLC | Durable Medical Equipment & Medical Supplies | 4810 Rainbow Dr., Jefferson City, MO 65109 | 2007-11-23 |
| Find all providers in zip 65109 | ||||
| Taxonomy Code | 152WC0802X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Specialization | Corneal and Contact Management |
| The professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea’s ability to sustain successful contact lens wear, and treatment of any external eye or corneal condition which can affect contact lens wear. |
| Notes: Source: American Optometric Association [1/1/2009: added definition, added source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184759284 | Ralph Melvin Butler | Optometrist | 401 Supercenter Dr, Walmart Vision Center, Jefferson City, MO 65101-8190 | 2007-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508086166 | Marlin B Neil | Optometrist | 12312 Olive Blvd Ste 150, Saint Louis, MO 63141-5468 | 2007-04-26 |
| 1114056231 | Kevin Greeley Lydon | Optometrist | 6764 Mexico Rd, Saint Peters, MO 63376-1505 | 2007-03-05 |
| 1972645919 | Thomas Stanley Sandler | Optometrist | Jc Penney Optical, 4 Mid Rivers Mall Drive, St. Peters, MO 63376 | 2007-02-13 |
| 1811039910 | Rick Jon Unsell | Optometrist | 7436 Nw River Park Dr, Parkville, MO 64152-5028 | 2007-02-13 |
| 1659421303 | Ira Nathan Ettinger | Optometrist | 1701 Aroy Dr., Washington, MO 63090 | 2007-01-12 |
| 1588722748 | Morio Miyamoto | Optometrist | 720 Olive St, Suite 420, Saint Louis, MO 63101-2338 | 2006-12-04 |
| 1578649547 | Lawrence Allen Aurich | Optometrist | 12420 So. 71 Highway, Grandview, MO 64030 | 2006-10-31 |
| 1093823924 | Jeffrey Donald Laferla | Optometrist | 8301 N Congress Ave, Kansas City, MO 64152-2041 | 2006-08-29 |
| 1356454060 | Frank Joseph Bier | Optometrist | 14037 Manchester Rd, Manchester, MO 63011-4513 | 2006-08-16 |
| 1548206576 | William H Gosnell | Optometrist | 17950 E 39th St S, Independence, MO 64055-3850 | 2006-06-20 |
| Find all providers with the same taxonomy | ||||
| City | JEFFERSON CITY |
| Zip Code | 65109 |
Please comment or provide details below to improve the information on BODENHAMER EYE CONSULTANTS, LLC.
| 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.