Individual provider Active NPI

Richard Loren Nelson, O.D.

  • Corneal and Contact Management Optometrist
  • Indianola, IA
National Provider Identifier
1437137429
Registry record updated Sep 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
01595 Issued in IA
Practice address
1500 N Jefferson Way
Indianola, IA 50125-1465
Phone
(515) 961-7573
Fax
(515) 961-7586
NPI assigned
Jan 9, 2006
Last updated
Sep 8, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 01595 IA Primary

Addresses

Primary practice location

1500 N Jefferson Way
Indianola, IA 50125-1465

Mailing address

12817 Ford TRL S
Indianola, IA 50125-8930
Phone (515) 961-7573

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040119000707 IA Practitioner - Optometry 4486552619 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1500 N Jefferson Way
Indianola, IA 50125-1465
Phone (515) 360-5326

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery58

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01595IAMDFamily Medicine Physician

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": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410134400000",
    "number": "1437137429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12817 FORD TRL S",
            "city": "INDIANOLA",
            "state": "IA",
            "postal_code": "501258930",
            "telephone_number": "515-961-7573",
            "fax_number": "515-961-7586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 N JEFFERSON WAY",
            "city": "INDIANOLA",
            "state": "IA",
            "postal_code": "501251465",
            "telephone_number": "515-961-7573",
            "fax_number": "515-961-7586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "RICHARD",
        "middle_name": "LOREN",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-09",
        "last_updated": "2014-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "IA",
            "license": "01595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianola, IA

Sources for this page

Verify at the official NPI Registry.