Wyatt Nash-Keller, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

723 Issued in SD

Practice address

1208 22ND Ave S
Brookings, SD 57006-2804

Phone

(605) 692-2020

Fax

(605) 692-9594

NPI assigned

Oct 18, 2012

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 1

Medicare fee-for-service enrollment

Enrolled in SD

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

Pacific University - College of Optometry, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tasha J. Jones, O.D. P.CGroup PAC ID 9739224023, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Tasha J. Jones, O.D. P.C

  • Optometrist
  • Brookings, SD
  • NPI 1861721730
  Medicare reassignment Care Compare group NPD
• Wyatt Nash-Keller OD Prof LLC

  • Optometrist
  • Brookings, SD
  • NPI 1730548975
  NPD (past) Authorized official
• LG Optical Enterprises

  • Eyewear Supplier
  • Brookings, SD
  • NPI 1306016407
  NPD (past)
• Vision Care Associates, LLP

  • Optometrist
  • Aberdeen, SD
  • NPI 1265502264
  NPD (past)

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

{
    "created_epoch": "1350518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592956800000",
    "number": "1124371992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1208 22ND AVE S",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570060284",
            "telephone_number": "605-692-2020",
            "fax_number": "605-692-9594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 22ND AVE S",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570062804",
            "telephone_number": "605-692-2020",
            "fax_number": "605-692-9594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASH-KELLER",
        "first_name": "WYATT",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-18",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SD",
            "license": "723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201465",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anthony Paul Murray, DC DACO CCSP
• Eric M. Murunga, MD
• Ashley Mutschelknaus, PHARMD
• My Chiropractic, Prof., LLC
• J. Gabriel Mydland, EDD LPC
• Nabeel Nasir, MD
• Michael Nass, DC
• Rhiannon K Nedland, LPCC
• New Perspectives Counseling
• Valerie Youego Ngatchou Hatton, MS, CDT

• Optometrist in Brookings, SD
• Providers in Brookings, SD by specialty
• Optometrist in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2020; 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.