Provider Demographics
NPI:1184758013
Name:JOHN E BATEMAN O D P C
Entity type:Organization
Organization Name:JOHN E BATEMAN O D P C
Other - Org Name:<UNAVAIL>
Other - Org Type:
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:
Authorized Official - Phone:402-296-2200
Mailing Address - Street 1:2380 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:PLATTSMOUTH
Mailing Address - State:NE
Mailing Address - Zip Code:68048-2367
Mailing Address - Country:US
Mailing Address - Phone:402-296-2200
Mailing Address - Fax:402-296-6055
Practice Address - Street 1:2380 8TH AVE
Practice Address - Street 2:
Practice Address - City:PLATTSMOUTH
Practice Address - State:NE
Practice Address - Zip Code:68048-2367
Practice Address - Country:US
Practice Address - Phone:402-296-2200
Practice Address - Fax:402-296-6055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========-00Medicaid
NET40241Medicare UPIN
NE089837Medicare ID - Type Unspecified
NE=========-00Medicaid