Active NPI
Heidi Kim, OD
- Optometrist
- Reno, NV
National Provider Identifier
1235524851
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 910
- Practice address
- 5385 Reno Corporate Dr Ste 100
Reno, NV 89511-2395 - Phone
- (775) 852-3937
- NPI assigned
- Mar 31, 2015
- Last updated
- Nov 13, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 15440 TLG | CA | |
| Optometrist | 152W00000X | 910 | NV | Primary |
Addresses
Primary practice location
5385 Reno Corporate Dr Ste 100
Reno, NV 89511-2395
Mailing address
5385 Reno Corporate Dr Ste 100
Reno, NV 89511-2395
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15440 TLG | CA | MD | Optometrist |
| 910 | NV | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wilson, Conkey & Associates, P.C. | Optometrist | Current | Accepting new patients |
| Wilson, Conkey & Associates, P.C. | Optometrist | Current | Accepting new patients |
Locations
620 Sierra Rose Dr
Reno, NV 89511
Phone (775) 689-4519
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1427760000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605225600000",
"number": "1235524851",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5385 RENO CORPORATE DR STE 100",
"city": "RENO",
"state": "NV",
"postal_code": "895112395"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5385 RENO CORPORATE DR STE 100",
"city": "RENO",
"state": "NV",
"postal_code": "895112395",
"telephone_number": "775-852-3937"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "HEIDI",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-03-31",
"last_updated": "2020-11-13",
"certification_date": "2020-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "15440 TLG",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NV",
"license": "910",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Reno, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.