4States Vision Express – Optometrist, NPI 1003320607

4States Vision Express is a healthcare provider. based in Pineville, Missouri. specializing in Optometrist. The organization holds a License No. T03487 (MO). The NPI Number for 4States Vision Express is 1003320607

Main info

Organization
Name
4States Vision Express
NPI
1003320607
Phone
(417) 223-3937
Address
5265 South Business 71
Authorized Official
DR. KEVIN MICHAEL GARDNER OWNER OD
Enumeration Date
20 November 2017
Last Update Date
16 October 2020
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness80
Years active:8State licenses:1Digital endpointsUpdated within 12 months

Provider Addresses for 4States Vision Express

  • 5265 South Business 71

    Suite B3

    Pineville, MO 64856

    Phone: (417) 223-3937

    Fax: (417) 223-3938

    Type: Location

  • West 26th Street, Joplin, Jasper County, Missouri, 64804, United States

    JOPLIN, MO 648041513

    Phone: (417) 925-2366

    Fax: (417) 925-2367

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2021-07-22

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Revalidation due soon

Earliest CMS due date is 2026-07-31 (52 days away).

Enrollment records

2

Earliest due date

2026-07-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20171109003472OClinic/Group PracticeMOTBD
O20210722003919OClinic/Group PracticeKS2026-07-31

What to do next

  • Confirm the due date on the CMS Revalidation Lookup Tool.
  • Complete revalidation in PECOS before the published due date.
  • If you have multiple enrollment records, revalidate each one on its own schedule.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 64856)

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Reviews

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Frequently asked questions

Can I cross-check 4States Vision Express using NPI 1003320607?
NPI 1003320607 belongs to 4States Vision Express; compare other details if you need extra assurance.
Is there an active status for 4States Vision Express?
For scheduling context, 4States Vision Express is shown as active in the registry.
How would a patient describe 4States Vision Express's focus?
For 4States Vision Express, the primary taxonomy reads as Optometrist. Clinical services aligned with this taxonomy classification.
Is 4States Vision Express associated with Pineville?
Public fields place 4States Vision Express around Pineville, Missouri. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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