Active NPI
Nebelsick Optometric PLLC
- Optometrist
- Rapid City, SD
National Provider Identifier
1366288219
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- Legal business name
- NEBELSICK OPTOMETRIC PLLC
- Practice address
- 409 Kansas City St
Rapid City, SD 57701-3636 - Phone
- (605) 348-2323
- Fax
- (605) 348-6694
- NPI assigned
- Jul 1, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jonathan Paul Nebelsick, OD
- Title
- Owner
- Phone
- (605) 999-0152
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | Primary |
Addresses
Primary practice location
409 Kansas City St
Rapid City, SD 57701-3636
Mailing address
23811 Kieffer Ranch Rd
Rapid City, SD 57702-7369
Phone (605) 999-0152
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SD
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
409 Kansas City St
Rapid City, SD 57701
Phone (605) 348-2323
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Optometrist
- Hot Springs, SD
- NPI 1659926160
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1719792000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1719792000000",
"number": "1366288219",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23811 KIEFFER RANCH RD",
"city": "RAPID CITY",
"state": "SD",
"postal_code": "577027369",
"telephone_number": "605-999-0152",
"fax_number": "605-348-6694"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "409 KANSAS CITY ST",
"city": "RAPID CITY",
"state": "SD",
"postal_code": "577013636",
"telephone_number": "605-348-2323",
"fax_number": "605-348-6694"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NEBELSICK OPTOMETRIC PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2024-07-01",
"last_updated": "2024-07-01",
"certification_date": "2024-07-01",
"status": "A",
"authorized_official_last_name": "NEBELSICK",
"authorized_official_first_name": "JONATHAN",
"authorized_official_middle_name": "PAUL",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "605-999-0152",
"authorized_official_credential": "OD"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rapid City, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; 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.