Individual provider Active NPI

Aimee Lynn Noll, O.D.

  • Optometrist
  • Henderson, NV
National Provider Identifier
1295142834
Registry record updated Jul 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
15055 Issued in CA
Practice address
2645 Saint Rose Pkwy Ste C-110
Henderson, NV 89052-4886
Phone
(702) 665-4960
Fax
(702) 665-6338
NPI assigned
Jul 15, 2014
Last updated
Jul 29, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2022

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

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 850 NV
Corneal and Contact Management Optometrist 152WC0802X 15055 CA
Corneal and Contact Management Optometrist 152WC0802X 850 NV
Low Vision Rehabilitation Optometrist 152WL0500X 15055 CA
Pediatric Optometrist 152WP0200X 15055 CA
Pediatric Optometrist 152WP0200X 850 NV
Occupational Vision Optometrist 152WX0102X 15055 CA
Occupational Vision Optometrist 152WX0102X 850 NV
Vision Therapy Optometrist 152WV0400X 15055 CA
Optometrist 152W00000X 15055 CA Primary

Addresses

Primary practice location

2645 Saint Rose Pkwy Ste C-110
Henderson, NV 89052-4886

Mailing address

2645 Saint Rose Pkwy Ste C-110
Henderson, NV 89052-4886
Phone (702) 665-4960

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160829002739 NV Practitioner - Optometry 2466775259 Reassigns benefits to 2 organizations
Practice locations: Henderson, NV

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11201 S Eastern Ave
Suite 110
Henderson, NV 89052-6200
Phone (702) 744-3937

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
850NVMDPediatric Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Girisgen & Kopolow OD, PC Optometrist Current Accepting new patients
Kopolow & Girisgen Professional Corporation Optometrist CurrentSince Jun 1, 2016 Accepting new patients
Nolloptometryllc Single Specialty CurrentSince Feb 25, 2020 Accepting new patients
Jimmy K. Lee, M.D. Inc. Single Specialty Past Accepting new patients

Locations

11201 S Eastern Ave
Ste 110
Henderson, NV 89052
Phone (702) 744-3937

2645 Saint Rose Pkwy
Ste C110
Henderson, NV 89052
Phone (702) 840-2020

4045 Spencer St
Ste A59
Las Vegas, NV 89119
Phone (702) 437-5521

7361 W Lake Mead Blvd
Ste 104
Las Vegas, NV 89128
Phone (702) 341-7254

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.

NPI Registry JSON

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

{
    "created_epoch": "1405382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1295142834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2645 SAINT ROSE PKWY STE C-110",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890524886",
            "telephone_number": "702-665-4960",
            "fax_number": "702-665-6338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2645 SAINT ROSE PKWY STE C-110",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890524886",
            "telephone_number": "702-665-4960",
            "fax_number": "702-665-6338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLL",
        "first_name": "AIMEE",
        "middle_name": "LYNN",
        "name_prefix": "Miss",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-15",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NV",
            "license": "850",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CA",
            "license": "15055",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NV",
            "license": "850",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "CA",
            "license": "15055",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "CA",
            "license": "15055",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "NV",
            "license": "850",
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "CA",
            "license": "15055",
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "NV",
            "license": "850",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "CA",
            "license": "15055",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "15055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.