MEDICARE: DR. LARRY D. ELLINGSON O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	201431154	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831159169
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LARRY D. ELLINGSON O.D.

Provider Business Mailing Address
First Line	:	4823 RAPID CREEK RD NE
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52240-7716
Country	:	US
Telephone Number	:	319-643-2304
Fax Number	:

Provider Business Practice Location Address
First Line	:	1451 CORAL RIDGE AVE
Second Line	:
City	:	CORALVILLE
State	:	IA
Zip	:	52241-2805
Country	:	US
Telephone Number	:	319-466-0644
Fax Number	:	319-466-0330

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2006
Last Update Date	:	01/06/2014

Similar Medicare Providers

1467651372 — ELLINGSON EYECARE, INC.
Practice Location Address:

1451 CORAL RIDGE AVE STE 518
CORALVILLE, IA
52241-2805

Practice Phone: 319-466-0644
Practice Fax: 319-466-0330

1578429049 — CAYLA KING
Practice Location Address:

1101 5TH ST
CORALVILLE, IA
52241-2903

Practice Phone: 319-344-4486
Practice Fax:

1730045881 — DANIEL DEJAPIN
Practice Location Address:

2240 9TH ST
CORALVILLE, IA
52241-1575

Practice Phone: 319-800-5564
Practice Fax:

1093679029 — PREMTHERAPY LLC
Practice Location Address:

2140 NORCOR AVE STE 111
CORALVILLE, IA
52241-9736

Practice Phone: 319-423-8494
Practice Fax:

1952266355 — KAITLYN NICOLE SEVERSON
Practice Location Address:

2769 HEARTLAND DR STE 303
CORALVILLE, IA
52241-2732

Practice Phone: 319-500-8051
Practice Fax:

1679438923 — SAMANTHA JEWEL JENKINS
Practice Location Address:

2213 2ND ST
CORALVILLE, IA
52241-1205

Practice Phone: 319-358-2406
Practice Fax: 319-358-9276

Directions to “ DR. LARRY D. ELLINGSON O.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.