Provider Demographics
NPI:1457406563
Name:NEWMAN VISION CARE LLC
Entity Type:Organization
Organization Name:NEWMAN VISION CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:NEWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-890-3937
Mailing Address - Street 1:919 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GOODLAND
Mailing Address - State:KS
Mailing Address - Zip Code:67735-2940
Mailing Address - Country:US
Mailing Address - Phone:785-890-3937
Mailing Address - Fax:785-890-3938
Practice Address - Street 1:919 MAIN ST
Practice Address - Street 2:
Practice Address - City:GOODLAND
Practice Address - State:KS
Practice Address - Zip Code:67735-2940
Practice Address - Country:US
Practice Address - Phone:785-890-3937
Practice Address - Fax:785-890-3938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1626152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSDH0576OtherRAILROAD MEDICARE PART B
KS200255000BMedicaid
KSDH0576OtherRAILROAD MEDICARE PART B
KS200255000BMedicaid
KS6042900001Medicare NSC
KS065152Medicare PIN