Individual provider Active NPI

Nida Steiner, O.D.

  • Optometrist
  • Nashville, TN
National Provider Identifier
1164519690
Registry record updated Apr 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD2788 Issued in TN
Practice address
6553 Rolling Fork Dr
Nashville, TN 37205-3954
Phone
(615) 942-8052
NPI assigned
Oct 6, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4532T TX
Optometrist 152W00000X OD2788 TN Primary

Addresses

Primary practice location

6553 Rolling Fork Dr
Nashville, TN 37205-3954

Mailing address

6553 Rolling Fork Dr
Nashville, TN 37205-3954
Phone (615) 942-8052

Other identifiers 2

IdentifierTypeStateIssuer
80833QOtherTXBLUE CROSS BLUE SHIELD
142002802MedicaidTX

Other names 1

  • Dr. Nida Petikun Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20100630000351 TN Practitioner - Optometry 7315078672 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OD2788TNMDOptometrist
4532TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Calvert Opthalmology PSC CurrentSince Aug 16, 2013 Accepting new patients
Clear Lake Eye Center LLP Optometrist Past Accepting new patients
Berkeley Eye Institute, PLLC Optometrist Past Accepting new patients
Calvert Opthalmology PSC Past Accepting new patients

Locations

100 Keeton Dr
Hopkinsville, KY 42240
Phone (270) 886-2050

290 Clear Sky Ct
Clarksville, TN 37043
Phone (270) 886-2050

2801 Wilma Rudolph Blvd
Ste 665
Clarksville, TN 37040
Phone (931) 552-2233

1800 Galleria Blvd
Ste 2321
Franklin, TN 37067
Phone (615) 771-7382

Interoperability endpoints

  • Direct secure messaging: nida.steiner.p2@direct.360care.nextgenshare.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271116800000",
    "number": "1164519690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6553 ROLLING FORK DR",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372053954",
            "telephone_number": "615-942-8052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6553 ROLLING FORK DR",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372053954",
            "telephone_number": "615-942-8052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEINER",
        "first_name": "NIDA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2010-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "4532T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "OD2788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "80833Q",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "142002802",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NIDA",
            "last_name": "PETIKUN",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.