Active NPI
William Novack, OD
- Optometrist
- Kansas City, MO
National Provider Identifier
1104093756
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- T02231
- Practice address
- 1225 W 103Rd St
Kansas City, MO 64114 - Phone
- (816) 941-6886
- Fax
- (816) 941-8839
- NPI assigned
- May 13, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | T02231 | MO | Primary |
Addresses
Primary practice location
1225 W 103Rd St
Kansas City, MO 64114
Mailing address
1225 W 103Rd St
Kansas City, MO 64114
Phone (816) 941-6886
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T02231 | MO | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Daniel R Novack OD LLC | Optometrist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Optometrist
- Independence, MO
- NPI 1982146114
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210636800000",
"number": "1104093756",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1225 W 103RD ST",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "64114",
"telephone_number": "816-941-6886",
"fax_number": "816-941-8839"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1225 W 103RD ST",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "64114",
"telephone_number": "816-941-6886",
"fax_number": "816-941-8839"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOVACK",
"first_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-13",
"last_updated": "2008-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MO",
"license": "T02231",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kansas City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.