Individual provider Active NPI

Nicole Dyan Verachtert, O.D.

  • Optometrist
  • Parkville, MO
National Provider Identifier
1073560108
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T03469 Issued in MO
Practice address
6325 Lewis Dr
Suite 114
Parkville, MO 64152-3699
Phone
(816) 505-0100
Fax
(816) 505-2301
NPI assigned
May 26, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X T03469 MO Primary

Addresses

Primary practice location

6325 Lewis Dr
Suite 114
Parkville, MO 64152-3699

Mailing address

6420 NW Forest CT
Parkville, MO 64152-3139
Phone (816) 880-0242

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040901001390 MO Practitioner - Optometry 5597730424 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Viking Vision IncGroup PAC ID 6103161120, 4 clinicians
Nass, IncGroup PAC ID 3476528845, 4 clinicians

Practice addresses (Care Compare)

5769 NE Antioch Rd
In Vision Eye Care Center Gladstone
Gladstone, MO 64119-2017
Phone (816) 454-3937

6325 Lewis Dr
Suite 114
Parkville, MO 64152-4505
Phone (816) 505-0100

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery38

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nass, Inc Optometrist CurrentSince Aug 1, 2004 Accepting new patients

Locations

6325 Lewis Dr
Ste 114
Parkville, MO 64152
Phone (816) 505-0100

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1073560108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6420 NW FOREST CT",
            "city": "PARKVILLE",
            "state": "MO",
            "postal_code": "641523139",
            "telephone_number": "816-880-0242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6325 LEWIS DR",
            "address_2": "SUITE 114",
            "city": "PARKVILLE",
            "state": "MO",
            "postal_code": "641523699",
            "telephone_number": "816-505-0100",
            "fax_number": "816-505-2301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERACHTERT",
        "first_name": "NICOLE",
        "middle_name": "DYAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T03469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parkville, MO

Sources for this page

Verify at the official NPI Registry.