Henry Lee Bumgardner Jr., O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

997-3 Issued in KS

Practice address

2205 S Seneca St
Wichita, KS 67213-4224

Phone

(316) 264-9131

Fax

(316) 264-4649

NPI assigned

Aug 31, 2006

Last updated

Oct 12, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in KS

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

Specialty

Optometry

Education

University of Houston - College of Optometry, 1969

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223769600000",
    "number": "1114039583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 S SENECA ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672134224",
            "telephone_number": "316-264-9131",
            "fax_number": "316-264-4649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 S SENECA ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672134224",
            "telephone_number": "316-264-9131",
            "fax_number": "316-264-4649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUMGARDNER",
        "first_name": "HENRY",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2008-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "997-3",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3239530",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL IDENTIFICATION #",
            "identifier": "480801828",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED PLUS KANSAS",
            "identifier": "130",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY",
            "identifier": "333128",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KANSAS OPTOMETRY LICENSE",
            "identifier": "997-3",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "005262",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kellis Bulleigh, M.D.
• Allison Bullinger, DPT
• Eli Bullinger
• Erin Catherine Bullinger
• Sarah A Bullinger, ARNP, NNP
• Larry Thomas Bumguardner, D.O.
• Cassandra Bumsted, RD,LD
• Eric Christopher Bunting, MD
• Mary Bunting
• Bunyan Homes LLC

• Optometrist in Wichita, KS
• Providers in Wichita, KS by specialty
• Optometrist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.