Sara Kristen Nicholson, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2990-035 Issued in WI

Practice address

4060 N Main St
Racine, WI 53402-3121

Phone

(262) 752-2020

Fax

(262) 292-5019

NPI assigned

May 3, 2006

Last updated

Jun 24, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Sara Kristen Legue Former name

Medicare fee-for-service enrollment

Enrolled in WI

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

Illinois College of Optometry at Chicago, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Allinfavor, Inc.

  dba Pearle Vision

  • Eyewear Supplier
  • Racine, WI
  • NPI 1538589304
  Medicare reassignment NPD Authorized official
• John E Warren OD SC

  dba Warren Eye Care Center Inc

  • Optometrist
  • Mount Pleasant, WI
  • NPI 1821113697
  NPD (past)

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214265600000",
    "number": "1184682775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1534 COLLEGE AVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534031949",
            "telephone_number": "262-989-9629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4060 N MAIN ST",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534023121",
            "telephone_number": "262-752-2020",
            "fax_number": "262-292-5019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "SARA",
        "middle_name": "KRISTEN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-03",
        "last_updated": "2008-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2990-035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARA",
            "last_name": "LEGUE",
            "middle_name": "KRISTEN",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Willard Nettles, MD
• Larry D Neumann, D.D.S
• Earl L Newton, DDS
• Jenice Ngirake, RN
• Lanphuong Nguyen, DDS
• Nicole's Nurturing Care
• Eric Leland Nielsen, RN
• Tara Danielle Nielsen, FNP-BC, APNP
• Deborah R Niesen, RN
• Julie Nigh

• Optometrist in Racine, WI
• Providers in Racine, WI by specialty
• Optometrist in Wisconsin

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