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
Last updated
Aug 1, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2013

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

Authorized official

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.

Specialties & licenses 1

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

Addresses

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD2 enrollments

Enrollment records 2

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 - OptometristDME Supplier - Optician 6608950688 Practice locations: Milbank, SD

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
43D2078031Milbank Eyecare Center224 S Main Street, Milbank, SD 57252Certificate of waiverMay 19, 2028

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Milbank Eyecare Center Prof LLC224 S Main St, Milbank, SD 57252-1809(605) 432-6666 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Mar 10, 2008

National Provider Directory

National Provider Directory

Locations

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

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "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.