Provider Demographics
NPI:1285728196
Name:INSIGHT EYECARE SPECIALTIES INC.
Entity type:Organization
Organization Name:INSIGHT EYECARE SPECIALTIES INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-795-7777
Mailing Address - Street 1:19045 EAST VALLEY VIEW PARKWAY,
Mailing Address - Street 2:SUITE A
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055-7030
Mailing Address - Country:US
Mailing Address - Phone:816-795-7777
Mailing Address - Fax:816-795-1290
Practice Address - Street 1:10217 NORTH OAK TRAFFIC WAY
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64155-1715
Practice Address - Country:US
Practice Address - Phone:816-476-4017
Practice Address - Fax:816-476-4021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002015841152W00000X
152W00000X, 207W00000X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO318751112Medicaid
MO318751138Medicaid
5232940001Medicare NSC
MO318751112Medicaid
MOU91878Medicare UPIN