Active NPI
Christine M Mikolaj, O.D.
- Optometrist
- Trussville, AL
National Provider Identifier
1356507891
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- R-182-TA-821
- Practice address
- 129 N Chalkville Rd
Trussville, AL 35173-1376 - Phone
- (205) 661-2080
- Fax
- (205) 661-2085
- NPI assigned
- Aug 4, 2008
- Last updated
- Mar 7, 2023
- Sex
- Female
- 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 | R-182-TA-821 | AL | Primary |
Addresses
Primary practice location
129 N Chalkville Rd
Trussville, AL 35173-1376
Mailing address
PO Box 1310
Trussville, AL 35173-6102
Phone (205) 661-2080
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 113066 | Medicaid | AL | |
| R-182-TA-821 | Other | AL | ALABAMA OPTOMETRY LICENSE |
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 |
|---|---|---|---|
| 1879 | KY | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brian Keplinger, O.D., PSC | 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": "1217808000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1356507891",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1310",
"city": "TRUSSVILLE",
"state": "AL",
"postal_code": "351736102",
"telephone_number": "205-661-2080",
"fax_number": "205-661-2085"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "129 N CHALKVILLE RD",
"city": "TRUSSVILLE",
"state": "AL",
"postal_code": "351731376",
"telephone_number": "205-661-2080",
"fax_number": "205-661-2085"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIKOLAJ",
"first_name": "CHRISTINE",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-04",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "AL",
"license": "R-182-TA-821",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "113066",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALABAMA OPTOMETRY LICENSE",
"identifier": "R-182-TA-821",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Trussville, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.