Organization Active NPI

Heather a Robben OD LLC

  • Optometrist
  • Wakeeney, KS
National Provider Identifier
1306111992
Registry record updated Jul 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1751 Issued in KS
Legal business name
HEATHER A ROBBEN OD LLC
Practice address
308 N 6TH St
Wakeeney, KS 67672-1802
Phone
(785) 743-5522
NPI assigned
Mar 14, 2012
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Dr. Heather A Robben, ODNPI 1407869092
Title
Optometrist
Phone
(785) 259-3097

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS2 enrollments

Medicare enrollment records 2

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20120518000487 KS Part B Supplier - Clinic/Group Practice 2365605912 Receives reassigned benefits from 3 practitioners
Practice locations: Wakeeney, KS
O20121018000283 KS DME Supplier - Physician - Optometrist 2365605912 Practice locations: Wakeeney, KS

National Provider Directory

National Provider Directory

Locations

310 N 6th St
Wakeeney, KS 67672
Phone (785) 743-5522

308 N 6th St
Wakeeney, KS 67672
Phone (785) 743-5522

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1751 KS Primary

Addresses

NPPES NPI Registry

Primary practice location

308 N 6TH St
Wakeeney, KS 67672-1802

Mailing address

PO Box 458
Wakeeney, KS 67672-0458
Phone (785) 743-5522

Other identifiers 4

NPPES NPI Registry
IdentifierTypeStateIssuer
200402860AMedicaidKS
6152030001OtherKSMEDICARE DME
651156OtherKSBLUE CROSS BLUE SHIELD
P00436065OtherKSMEDICARE RAILROAD

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 9, 2013.

{
    "created_epoch": "1331683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373328000000",
    "number": "1306111992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 458",
            "city": "WAKEENEY",
            "state": "KS",
            "postal_code": "676720458",
            "telephone_number": "785-743-5522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 N 6TH ST",
            "city": "WAKEENEY",
            "state": "KS",
            "postal_code": "676721802",
            "telephone_number": "785-743-5522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEATHER A ROBBEN OD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-14",
        "last_updated": "2013-07-09",
        "status": "A",
        "authorized_official_last_name": "ROBBEN",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "785-259-3097",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1751",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200402860A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DME",
            "identifier": "6152030001",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "651156",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00436065",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wakeeney, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.