NPIMap

Individual provider Active NPI

Kristen M Zeller, OD

  • Optometrist
  • Omaha, NE
National Provider Identifier
1356629463
Registry record updated Jun 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1371 Issued in NE
Practice address
6751 N 72ND St
Suite 105
Omaha, NE 68122-1746
Phone
(402) 572-2020
Fax
(402) 572-2150
NPI assigned
Jul 25, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 002526 IA
Optometrist 152W00000X 1371 NE Primary

Addresses

Primary practice location

6751 N 72ND St
Suite 105
Omaha, NE 68122-1746

Mailing address

6751 N 72ND St
Suite 105
Omaha, NE 68122-1746
Phone (402) 572-2020

Other names 1

  • Kristen M Brumm Former name

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

LicenseStateTypeSpecialty
002526IAMDOptometrist
1371NEMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1311552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466985600000",
    "number": "1356629463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6751 N 72ND ST",
            "address_2": "SUITE 105",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681221746",
            "telephone_number": "402-572-2020",
            "fax_number": "402-572-2150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6751 N 72ND ST",
            "address_2": "SUITE 105",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681221746",
            "telephone_number": "402-572-2020",
            "fax_number": "402-572-2150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZELLER",
        "first_name": "KRISTEN",
        "middle_name": "M",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-25",
        "last_updated": "2016-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "002526",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NE",
            "license": "1371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "BRUMM",
            "middle_name": "M",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.