Kurt Kenneth Nelson, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

Practice address

629 N Galena Ave
Dixon, IL 61021-1664

Phone

(815) 284-6866

Fax

(815) 284-2388

NPI assigned

Dec 5, 2006

Last updated

Jul 9, 2007By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 1976

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1285792093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 N GALENA AVE",
            "address_2": "P.O. BOX 572",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610211664",
            "telephone_number": "815-284-6866",
            "fax_number": "815-284-2388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 N GALENA AVE",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610211664",
            "telephone_number": "815-284-6866",
            "fax_number": "815-284-2388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "KURT",
        "middle_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Mysliwiec
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• Jaclyn Nauman, RBT
• Jaden Nave, RBT
• Sandra Ann Nealon
• Uyen Nguyen, DO
• Kristen Nichols, MS, QMHP, CADC
• Natasha Denise Noel, M.D.
• Lurana Noorlag, RBT
• Addyson North, RBT

• Optometrist in Dixon, IL
• Providers in Dixon, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.