Organization Active NPI

Milbank Eyecare Center, Prof. L.L.C.

  • Optometrist
  • Milbank, SD
National Provider Identifier
1578747143
Registry record updated Aug 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
583 Issued in SD
Legal business name
MILBANK EYECARE CENTER, PROF. L.L.C.
Practice address
224 S Main St
Milbank, SD 57252-1809
Phone
(605) 432-6666
Fax
(605) 432-9255
NPI assigned
Dec 19, 2007
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Dr. Nicholas R Gilmore, O.D.NPI 1124079223
Title
Owner
Phone
(605) 432-6666

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
43D2078031Milbank Eyecare Center
224 S Main Street, Milbank, SD 57252
Certificate of waiverMay 19, 2028

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Milbank Eyecare Center Prof LLC
224 S Main St, Milbank, SD 57252-1809 · (605) 432-6666
Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignment
Participating since Mar 10, 2008

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in SD

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20080229000096 SD Part B Supplier - Clinic/Group Practice 6608950688 Receives reassigned benefits from 2 practitioners
Practice locations: Milbank, SD
O20100930020494 SD DME Supplier - Physician - Optometrist
DME Supplier - Optician
6608950688 Practice locations: Milbank, SD

National Provider Directory

Locations

224 S Main St
Milbank, SD 57252
Phone (605) 432-6666

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 583 SD Primary

Addresses

NPPES NPI Registry

Primary practice location

224 S Main St
Milbank, SD 57252-1809

Mailing address

224 S Main St
Milbank, SD 57252-1809
Phone (605) 432-6666

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 1, 2013.

{
    "created_epoch": "1198022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375315200000",
    "number": "1578747143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 S MAIN ST",
            "city": "MILBANK",
            "state": "SD",
            "postal_code": "572521809",
            "telephone_number": "605-432-6666",
            "fax_number": "605-432-9255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 S MAIN ST",
            "city": "MILBANK",
            "state": "SD",
            "postal_code": "572521809",
            "telephone_number": "605-432-6666",
            "fax_number": "605-432-9255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILBANK EYECARE CENTER, PROF. L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-19",
        "last_updated": "2013-08-01",
        "status": "A",
        "authorized_official_last_name": "GILMORE",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "605-432-6666",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "SD",
            "license": "583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milbank, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.