Provider Demographics
NPI:1437154705
Name:GERING VISION CENTER, P.C.
Entity Type:Organization
Organization Name:GERING VISION CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:WASSERBURGER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:308-436-3176
Mailing Address - Street 1:1605 10TH ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:GERING
Mailing Address - State:NE
Mailing Address - Zip Code:69341-2409
Mailing Address - Country:US
Mailing Address - Phone:308-436-3176
Mailing Address - Fax:308-436-9105
Practice Address - Street 1:1605 10TH ST
Practice Address - Street 2:SUITE B
Practice Address - City:GERING
Practice Address - State:NE
Practice Address - Zip Code:69341-2409
Practice Address - Country:US
Practice Address - Phone:308-436-3176
Practice Address - Fax:308-436-9105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-14
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE789152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE36782OtherBLUE CROSS BLUE SHIELD
NENE0789OtherEYEMED PROVIDER #
NE36782OtherBLUE CROSS BLUE SHIELD
NE36782OtherBLUE CROSS BLUE SHIELD
NE273722Medicare PIN
NET40275Medicare UPIN
NE=========00Medicaid
NENA2452Medicare PIN