MISTY MARIE WATTERS (NPI# 1720286784) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720286784 |
| Entity Type | Individual |
| Full Name | MISTY MARIE WATTERS |
| Credential | O.D. |
| Practice Address |
310 W Main St Sparta WI 54656 |
| Mailing Address |
Po Box 1510 Eau Claire WI 54702-1510 |
| Practice Telephone | 6087850940 |
| Mailing Telephone | 6087850940 |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2020-09-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 3079-035 | WI | Eye and Vision Services Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 800 West Ave S, La Crosse, WI 546018806 | 6087829760 |
| Street Address |
310 W MAIN ST |
| City | SPARTA |
| State | WI |
| Zip Code | 54656 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518961978 | James H Piper | Nurse Anesthetist, Certified Registered | 310 W Main St, Sparta, WI 54656-2170 | 2005-06-13 |
| 1003398488 | Ariel Dawn Ferdock | Pharmacist | 310 W Main St, Sparta, WI 54656 | 2018-09-03 |
| 1750898680 | Heidi Marie Stenerson | Nurse Practitioner | 310 W Main St, Sparta, WI 54656-2170 | 2017-12-30 |
| 1992243984 | Alex Grunenwald | Emergency Medicine | 310 W Main St, Sparta, WI 54656-2170 | 2017-02-09 |
| 1801343066 | Laura Kathryn Mitchell | Nurse Practitioner | 310 W Main St, Sparta, WI 54656-2170 | 2016-09-06 |
| 1760852719 | Denise Weber | Social Worker | 310 W Main St, Sparta, WI 54656-2170 | 2015-10-03 |
| 1871963462 | Anna Klusendorf | Physical Therapist | 310 W Main St, Sparta, WI 54656 | 2015-09-25 |
| 1013399419 | Bahram Badri | Family Medicine | 310 W Main St, Sparta, WI 54656 | 2015-06-22 |
| 1902104102 | Katarzyna Luce | Physical Therapist | 310 W Main St, Sparta, WI 54656 | 2011-03-11 |
| 1487989125 | Derrick L Woodward | Family Medicine | 310 W Main St, Sparta, WI 54656 | 2009-10-14 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669929279 | Jennifer Johnson | Physical Therapy Assistant | 14345 County Hwy B, Sparta, WI 54656 | 2016-09-01 |
| 1578019899 | M&t Performance Chiropractic, LLC | Chiropractor | 213 N Black River St, Sparta, WI 54656 | 2016-08-28 |
| 1801223003 | Emily M Nolte | Counselor | 112 S Court St. Room 3000, Sparta, WI 54656 | 2013-10-02 |
| 1518254945 | Therapeutic Home Services | Point of Service | 9484 Festival Avenue, Sparta, WI 54656 | 2011-07-06 |
| 1639488273 | Rebecca Ann Frey | Reflexologist | 5680 Canary Ave, Sparta, WI 54656 | 2010-09-30 |
| 1316276660 | Gary J Korthals | Pharmacist | 201 S. Water St, Sparta, WI 54656 | 2009-12-16 |
| 1689847329 | Donald N. La Force | Hearing Instrument Specialist | 117 West Oak St, Sparta, WI 54656 | 2008-04-02 |
| 1164400503 | Alice M Bachop | Nurse Practitioner | 310 West Main Street, Sparta, WI 54656 | 2006-01-05 |
| 1578540894 | Marc D Tumerman | Family Medicine | 310 West Main St, Sparta, WI 54656 | 2005-12-28 |
| 1972001881 | Carmen Alyssa Adams | Physician Assistant | 1111 W Wisconsin St, Sparta, WI 54656 | 2018-01-25 |
| Find all providers in zip 54656 | ||||
| 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 |
|---|---|---|---|---|
| 1972141877 | Mullins Vision South, Pllc | Optometrist | 126 E Bockman Way, Sparta, TN 38583-2036 | 2019-12-11 |
| 1679115836 | Peli Eyecare and Associates | Optometrist | 10 North Village Boulevard, Suite C, Sparta, NJ 07871 | 2019-10-09 |
| 1467907063 | Logan Oliver | Optometrist | 18 Grayson St, Sparta, NC 28675-6006 | 2016-08-24 |
| 1841678927 | Stella Lee | Optometrist | 1 Wilson Dr, Sparta, NJ 07871-4416 | 2015-05-11 |
| 1689904682 | Anne M. Pfeffer O.d., Pllc | Optometrist | 570 S State St Ste B, Sparta, MI 49345-1524 | 2010-01-13 |
| 1851579056 | Keith Oliver Dr | Optometrist | 18 S Grayson St, Sparta, NC 28675-9598 | 2008-02-11 |
| 1639350424 | Mark Zaleski T/a Albert Minelli Opticians | Optometrist | 55 Sparta Ave, Sparta, NJ 07871-1815 | 2007-11-20 |
| 1144375866 | Southern Illinois Eyecare, PC | Optometrist | 520 E Broadway St, Sparta, IL 62286-1889 | 2007-01-24 |
| 1326128810 | Anne Michelle Pfeffer | Optometrist | 343 S Union St, Sparta, MI 49345-1531 | 2006-10-17 |
| 1457310203 | David Ryan Harkema | Optometrist | 38 N Union St, Sparta, MI 49345-1138 | 2006-03-21 |
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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.