Active NPI
Phil Douglas Farmer, OD
- Optometrist
- Pratt, KS
National Provider Identifier
1184796112
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 10063
- Practice address
- 203 Watson St
Pratt, KS 67124-3066 - Phone
- (620) 672-5934
- Fax
- (620) 672-3550
- NPI assigned
- Nov 14, 2006
- Last updated
- Jul 8, 2007
- 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 | 10063 | KS | Primary |
Addresses
Primary practice location
203 Watson St
Pratt, KS 67124-3066
Mailing address
PO Box 1024
Pratt, KS 67124-1024
Phone (620) 672-5934
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 |
|---|---|---|---|
| 10063 | KS | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grene Vision Group LLC | Optometrist | Past | Accepting new patients |
| Maydew Thibault Optometry LLC | Optometrist | Past | Accepting new patients |
| Grene Vision Group LLC | Optometrist | Past | Accepting new patients |
| Maydew Thibault Optometry LLC | Optometrist | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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- Medicine Lodge, KS
- NPI 1720132715
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1184796112",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1024",
"city": "PRATT",
"state": "KS",
"postal_code": "671241024",
"telephone_number": "620-672-5934",
"fax_number": "620-672-3550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "203 WATSON ST",
"city": "PRATT",
"state": "KS",
"postal_code": "671243066",
"telephone_number": "620-672-5934",
"fax_number": "620-672-3550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FARMER",
"first_name": "PHIL",
"middle_name": "DOUGLAS",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "KS",
"license": "10063",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pratt, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.