Gregory M Neilsen (NPI# 1144272097, PAC ID# 9739192915) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OPTOMETRY.
| Nation Provider ID (NPI) | 1144272097 |
| PAC ID by PECOS | 9739192915 |
| Professional Enrollment ID | I20060712000072 |
| Full Name | Gregory M Neilsen |
| Organization Legal Name | SHOPKO STORES OPERATING CO LLC |
| Address |
3025 Hamiton Blvd Shopko Optical 040 Sioux City IA 51104-2407 |
| Phone Number | 7122555869 |
| Gender | M |
| Credential | OD |
| Medical School | ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO |
| Graduation Year | 1976 |
| Primary Specialty | OPTOMETRY |
| Group Practice PAC ID | 0749292639 |
| Number of Group Practice Members | 136 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 3025 Hamiton Blvd, Shopko Optical 040, Sioux City, IA 51104-2407 | 7122555869 | SHOPKO STORES OPERATING CO LLC |
| 3025 Hamiton Blvd, Sioux City, IA 51104-2407 | 7122555869 | SHOPKO STORES OPERATING CO LLC |
| Organization Legal Name | SHOPKO STORES OPERATING CO LLC |
| Physicians | 40 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Taylor L Douglas | Optometry | Shopko Stores Operating Co LLC | 900 W Memorial Rd, Shopko Optical 123, Houghton, MI 44931-2481 |
| James D Mckell | Optometry | Shopko Stores Operating Co LLC | 955 N Main St, Spanish Fork, UT 84660-1150 |
| Kelly Rd Mccarthy | Optometry | Shopko Stores Operating Co LLC | 510 E Philip Ave, North Platte, NE 69101-5538 |
| Jodi A Bergstrom | Optometry | Shopko Stores Operating Co LLC | 801 W Central Entrance, Duluth, MN 55811-5468 |
| Kellye P Zaporski | Optometry | Shopko Stores Operating Co LLC | 701 S Church St, Watertown, WI 53094-6213 |
| Theresa M Dellaert | Optometry | Shopko Stores Operating Co LLC | 255 John F Kennedy Rd, Dubuque, IA 52002-5313 |
| Karl T Jepson | Optometry | Shopko Stores Operating Co LLC | 510 E Phillip Ave, North Platte, NE 69101-5538 |
| Jared W Nelson | Optometry | Shopko Stores Operating Co LLC | 747 S Main St, Brigham City, UT 84302-3359 |
| Margaret A Wolan | Optometry | Shopko Stores Operating Co LLC | 7401 Mineral Point Rd, Madison, WI 53717-1703 |
| Robert P Todd | Optometry | Shopko Stores Operating Co LLC | 211 S 23rd St, Shopko Optical 4662, Plattsmouth, NE 68048-2903 |
| Street Address |
3025 HAMITON BLVD SHOPKO OPTICAL 040 |
| City | SIOUX CITY |
| State | IA |
| Zip | 51104-2407 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| David J Korver | Optometry | Shopko Stores Operating Co LLC | 3025 Hamiton Blvd, Shopko Optical 040, Sioux City, IA 51104-2407 |
| Benjamin T Iwai | Optometry | Shopko Stores Operating Co LLC | 3025 Hamiton Blvd, Shopko Optical 040, Sioux City, IA 51104-2407 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Gary D Heath | Physician Assistant | Family Health Care of Siouxland Plc | 4230 Hamilton Blvd, Sioux City, IA 51104-1137 |
| Joseph Adam Kurth | Family Medicine | Family Health Care of Siouxland Plc | 4230 Hamilton Blvd, Sioux City, IA 51104-1137 |
| Amy J Payne | Physician Assistant | Family Health Care of Siouxland Plc | 4230 Hamilton Blvd, Sioux City, IA 51104-1137 |
| Shannon Stewart | Nurse Practitioner | Family Health Care of Siouxland Plc | 4230 Hamilton Blvd, Sioux City, IA 51104-1137 |
| Michael D. Harder | Family Medicine | Family Health Care of Siouxland Plc | 4230 Hamilton Blvd, Sioux City, IA 51104-1137 |
| Michelle Renae Doty | Nurse Practitioner | Family Health Care of Siouxland Plc | 4230 Hamilton Blvd, Sioux City, IA 51104-1137 |
| Kerri A Weaver | Clinical Social Worker | Family Health Care of Siouxland Plc | 4230 Hamilton Blvd, Sioux City, IA 51104-1137 |
| Cynthia S Lewin | Nurse Practitioner | Family Health Care of Siouxland Plc | 4230 Hamilton Blvd, Sioux City, IA 51104-1137 |
| Roxana B Karimzadeh | Physician Assistant | Family Health Care of Siouxland Plc | 4230 Hamilton Blvd, Sioux City, IA 51104-1137 |
| Steven L Shook | Family Practice | Family Health Care of Siouxland Plc | 4230 Hamilton Blvd, Sioux City, IA 51104-1137 |
| Find all physicians in zip 51104 | |||
| City | SIOUX CITY |
| Zip Code | 51104 |
| Specialty | OPTOMETRY |
| City + Specialty | SIOUX CITY + OPTOMETRY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.