| Custom Vision, Inc. | |
|
3660 Ne Ralph Powell Rd, Lees Summit, MO 64064-2357 | |
| (816) 524-7400 | |
| Not Available |
| Full Name | Custom Vision, Inc. |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 3660 Ne Ralph Powell Rd, Lees Summit, Missouri |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619004280 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | TO2926 (Missouri) | Primary |
| Provider Name | Linda Gail Drake |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1467487165 PECOS PAC ID: 9234197955 Enrollment ID: I20041230000405 |
| Provider Name | Scott Adrian Drake |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1407881105 PECOS PAC ID: 1052379773 Enrollment ID: I20041230000458 |
| Provider Name | Jeffrey Paul Enevoldsen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1558617993 PECOS PAC ID: 9739339367 Enrollment ID: I20130807000322 |
| Provider Name | Christopher E Cossette |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1629483268 PECOS PAC ID: 0648496778 Enrollment ID: I20140728000527 |
| Provider Name | Jennifer L Luebbe |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1184039711 PECOS PAC ID: 6608092960 Enrollment ID: I20140801001147 |
| Provider Name | Alicia M Genilo |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1962060293 PECOS PAC ID: 8921332297 Enrollment ID: I20190620003051 |
| Mailing Address | Practice Location Address |
|---|---|
| Custom Vision, Inc. 3660 Ne Ralph Powell Rd, Lees Summit, MO 64064-2357 Ph: (816) 524-7400 | Custom Vision, Inc. 3660 Ne Ralph Powell Rd, Lees Summit, MO 64064-2357 Ph: (816) 524-7400 |
Envision Eyecare, Llc Optometrist Medicare: Medicare Enrolled Practice Location: 215 Se State Route 291, Lees Summit, MO 64063 Phone: 816-246-7779 Fax: 816-246-7780 | |
Dr. David E Orson, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 3536 Sw Market St, Lees Summit, MO 64082 Phone: 816-537-0011 Fax: 816-537-0402 | |
Dr. Laura Jean Nennig I, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 221 Nw Mcnary Ct, Lees Summit, MO 64086 Phone: 816-524-8900 | |
Dr. Wynter M Brown, O.D Optometrist Medicare: Not Enrolled in Medicare Practice Location: 3410 Sw Market St, Lees Summit, MO 64082 Phone: 816-623-3285 Fax: 816-623-3264 | |
Robert K Hartnett, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 4405 Ne Courtney Dr, Lees Summit, MO 64064 Phone: 626-644-8443 | |
Jackson County Eye Clinic Inc. Optometrist Medicare: Medicare Enrolled Practice Location: 221 Nw Mcnary Ct, Lees Summit, MO 64086 Phone: 816-524-8900 Fax: 816-525-2042 | |
Sara Elizabeth Stockwell, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 301 Ne Mulberry St Ste 101, Lees Summit, MO 64086 Phone: 816-525-3937 Fax: 816-587-3555 |