Colleen Personett, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

A192 Issued in AK

Practice address

1867 Airport Way
Ste 150a
Fairbanks, AK 99701-4061

Phone

(907) 452-2131

NPI assigned

Dec 6, 2006

Last updated

Mar 3, 2017By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AK

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

Pennsylvania College of Optometry, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Colleen Personett, OD, LLC

  • Optometrist
  • Fairbanks, AK
  • NPI 1588800817
  Medicare reassignment Authorized official
• Personett Family Eyecare, LLC

  • Optometrist
  • Fairbanks, AK
  • NPI 1154576213
  NPD (past)

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488499200000",
    "number": "1295894103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1214 RIDGEPOINTE DR",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997095737",
            "telephone_number": "907-388-7507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1867 AIRPORT WAY",
            "address_2": "STE 150A",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014061",
            "telephone_number": "907-452-2131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERSONETT",
        "first_name": "COLLEEN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-06",
        "last_updated": "2017-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AK",
            "license": "A192",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OE008289T",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jill Perkins, BSN
• Lizette Elena Pernas
• Sandra Katheryn Perry, RN
• Personett Family Eyecare, LLC
• Chad D Personett, OD
• Karissa Persson, RN
• Tammi Persson
• Michelle Peschke
• Petaloso Inc (Petaloso)
• Pete B Higgins DDS LLC (Four Corners Dental Group)

• Optometrist in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Optometrist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2017; 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.