Active NPI
Breckenridge Charles Dilly, O.D
- Optometrist
- Manhattan, KS
National Provider Identifier
1326029216
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- KS-1546
- Practice address
- 3012 Anderson Ave
Manhattan, KS 66503-2809 - Phone
- (785) 537-1118
- Fax
- (785) 537-8005
- NPI assigned
- Nov 8, 2005
- Last updated
- Jul 1, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | KS-1546 | KS | Primary |
Addresses
Primary practice location
3012 Anderson Ave
Manhattan, KS 66503-2809
Mailing address
2800 SW Wanamaker Rd
Suite 192
Topeka, KS 66614-4293
Phone (785) 272-0707
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 650723 | Other | BCBS | |
| 650771 | Other | BCBS | |
| 100361140C | Medicaid | KS | |
| 410048649 | Other | KS | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| KS-1546 | KS | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DRS Price Young Odle & Horsch PA | Optometrist | Past | Accepting new patients |
Organizations & group practices 1
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": "1131408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214870400000",
"number": "1326029216",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2800 SW WANAMAKER RD",
"address_2": "SUITE 192",
"city": "TOPEKA",
"state": "KS",
"postal_code": "666144293",
"telephone_number": "785-272-0707",
"fax_number": "785-271-1512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3012 ANDERSON AVE",
"city": "MANHATTAN",
"state": "KS",
"postal_code": "665032809",
"telephone_number": "785-537-1118",
"fax_number": "785-537-8005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DILLY",
"first_name": "BRECKENRIDGE",
"middle_name": "CHARLES",
"name_prefix": "Dr.",
"credential": "O.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-08",
"last_updated": "2008-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "KS",
"license": "KS-1546",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "650723",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "650771",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100361140C",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "410048649",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Manhattan, KS
- Lynn Difede, PT, DPT
- Mackenzie Erin Dikeman, MD
- Dillon Companies LLC (Dillon Pharmacy)
- Dillon Companies LLC (Dillon Pharmacy)
- Kamryn Dillon
- Sara Nicole Dirks, SLP
- Molly Beth Lindquist Disbrow, MD
- Discover Chiropractic, LLC (HealthSource Chiropractic)
- Discover Integrated Medicine LLC
- Kimberlynn Ann Dittemore, O.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.