Coffeyville Optic Shop LLC
NPI 1356005961 · Optician · Coffeyville, KS
Enrolled with Medicare as Dme Supplier - Optician · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Coffeyville Optic Shop LLC is a Optician organization in Coffeyville, KS (NPI 1356005961).
Provider details
- NPI number
- 1356005961
- Entity type
- Organization
- Primary specialty
- OpticianEye and Vision Services Providers
- Organization subpart
- No
- Authorized official
- Cynthia Dale, Owner(620) 870-4511
Specialties & taxonomies
Eye and Vision Services Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2021-10-29
- Last updated
- 2021-10-29
- Certified
- 2021-10-29
Frequently asked questions
- What is Coffeyville Optic Shop LLC's NPI number?
- Coffeyville Optic Shop LLC's National Provider Identifier (NPI) is 1356005961, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Coffeyville Optic Shop LLC?
- Coffeyville Optic Shop LLC is classified in the NPPES registry as Optician (Eye and Vision Services Providers).
- Where is Coffeyville Optic Shop LLC located?
- Coffeyville Optic Shop LLC's practice location on file with NPPES is 2205 W 8th St Ste B, Coffeyville, KS 67337-2950.
- What is Coffeyville Optic Shop LLC's phone number?
- The practice phone number listed in the NPPES registry for Coffeyville Optic Shop LLC is (620) 251-0050.
- Does Coffeyville Optic Shop LLC accept Medicare?
- Coffeyville Optic Shop LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Coffeyville Optic Shop LLC?
- The authorized official listed on Coffeyville Optic Shop LLC's NPPES record is Cynthia Dale, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Coffeyville Optic Shop LLC's NPI active?
- Yes — Coffeyville Optic Shop LLC's NPI (1356005961) is active in the NPPES registry as of the last update on 2021-10-29.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.