Kyle M Cheatham, O. D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

02373 Issued in IA

Practice address

2514 W Broadway
Council Bluffs, IA 51501-3509

Phone

(712) 322-3097

Fax

(712) 322-4130

NPI assigned

Sep 16, 2006

Last updated

Sep 12, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 9

Medicare fee-for-service enrollment

Enrolled in NE, IA2 enrollments

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 2

Specialty

Optometry

Education

Indiana University - School of Optometry, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vision Specialists of Papillion LLCGroup PAC ID 8729320411, 6 clinicians

Vision Specialists of Council Bluffs LLCGroup PAC ID 4183793938, 6 clinicians

Vision Specialists of Omaha LLCGroup PAC ID 7719212307, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Vision Specialists of Omaha LLC

  • Optometrist
  • Omaha, NE
  • NPI 1912564212
  Medicare reassignment Care Compare group NPD Authorized official
• Vision Specialists of Papillion LLC

  • Optometrist
  • Papillion, NE
  • NPI 1659859734
  Medicare reassignment Care Compare group NPD Authorized official
• Vision Specialists of Council Bluffs LLC

  • Optometrist
  • Council Bluffs, IA
  • NPI 1831377084
  Medicare reassignment Care Compare group Authorized official
• Vision Specialists of Clocktower Village, LLC

  • Optometrist
  • Omaha, NE
  • NPI 1326559725
  Authorized official Same address or phone
• Vision Specialists on Harrison LLC

  • Optometrist
  • Omaha, NE
  • NPI 1407457690
  Authorized official Same address or phone
• Olson Eye Care PLC

  • Optometrist
  • Council Bluffs, IA
  • NPI 1164774568
  NPD (past)
• Tye Inc

  dba lyn optical

  • Durable Medical Equipment & Medical Supplies
  • Council Bluffs, IA
  • NPI 1801983010
  NPD (past)

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1568568384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2514 W BROADWAY",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515013509",
            "telephone_number": "711-322-3097",
            "fax_number": "712-322-4130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2514 W BROADWAY",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515013509",
            "telephone_number": "712-322-3097",
            "fax_number": "712-322-4130"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3606 N 156th St Ste 105",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681162163",
            "country_code": "US",
            "telephone_number": "402-205-0754",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "120 Olson Dr Ste 107",
            "address_purpose": "LOCATION",
            "city": "Papillion",
            "state": "NE",
            "postal_code": "680462961",
            "country_code": "US",
            "telephone_number": "402-504-4257",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHEATHAM",
        "first_name": "KYLE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "O. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NE",
            "license": "1267",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "02373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025382400",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "99831",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO RAILROAD",
            "identifier": "P00397521",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0790470",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "614965001",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "99644",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IA",
            "identifier": "32830",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NE",
            "identifier": "37153",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NE",
            "identifier": "37192",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ann Chambers, RDH
• Chapters Council Bluffs Opco LLC (Chapters Living of Council Bluffs)
• Chartwell Pharmacy LLC (Serviam Pharmacy of Council Bluffs)
• Emily Chavez, NP
• Yuttana Chawengsub, M.D., PH.D.
• Thomas Francis Cheatle, MD
• Michael Chen, DO
• CHI Health Clinic Physician Enterprise-Anesthesia LLC
• Kudzai Chikwava, DDS
• Children's Dentistry of Council Bluffs, P.C.

• Optometrist in Council Bluffs, IA
• Providers in Council Bluffs, IA by specialty
• Optometrist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.