Provider Demographics
NPI:1568595007
Name:JOHN E BATEMAN O D P C
Entity Type:Organization
Organization Name:JOHN E BATEMAN O D P C
Other - Org Name:ELITE EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:JAE
Authorized Official - Last Name:CARDA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:402-296-2200
Mailing Address - Street 1:705 N 17TH AVE
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68003-1209
Mailing Address - Country:US
Mailing Address - Phone:402-944-3339
Mailing Address - Fax:402-944-3330
Practice Address - Street 1:705 N 17TH AVE
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:NE
Practice Address - Zip Code:68003-1209
Practice Address - Country:US
Practice Address - Phone:402-944-3339
Practice Address - Fax:402-944-3330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========-01Medicaid
NE89836BAMedicare ID - Type Unspecified
NE=========-01Medicaid
NE0429720002Medicare NSC