Active NPI
Bruce Anthony Anderson, OD
- Optometrist
- Lincoln, NE
National Provider Identifier
1104938281
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 967
- Practice address
- 6400 O St
Lincoln, NE 68510-2351 - Phone
- (702) 465-3368
- NPI assigned
- Aug 31, 2006
- 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 | 967 | NE | Primary |
Addresses
Primary practice location
6400 O St
Lincoln, NE 68510-2351
Mailing address
7820 S 28TH St
Lincoln, NE 68516-5870
Phone (308) 760-3184
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 76025834700 | Medicaid | NE | |
| 0341800001 | Other | CGLIC CIGNA | |
| 410019713 | Other | RAILROAD MEDICARE |
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 |
|---|---|---|---|
| 967 | NE | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Creston M. Myers, OD, PC | 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
- Alliance, NE
- NPI 1164794863
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1365120000000",
"number": "1104938281",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7820 S 28TH ST",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685165870",
"telephone_number": "308-760-3184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6400 O ST",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685102351",
"telephone_number": "702-465-3368"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "BRUCE",
"middle_name": "ANTHONY",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2013-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NE",
"license": "967",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "76025834700",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CGLIC CIGNA",
"identifier": "0341800001",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "410019713",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Lincoln, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.