NPIMap

Organization Active NPI

Lyndon Graves, P.C.

  • Optometrist
  • Omaha, NE
National Provider Identifier
1598714008
Registry record updated Mar 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
998 Issued in NE
Legal business name
LYNDON GRAVES, P.C.
Practice address
9239 W Center Rd
Suite 103
Omaha, NE 68124-1933
Phone
(402) 898-3232
Fax
(402) 898-3234
NPI assigned
May 10, 2006
Last updated
Mar 23, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2011

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

Authorized official

Name
Lyndon Jay Graves, O.D.NPI 1205886736
Title
Owner/Optometrist
Phone
(402) 898-3232

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 998 NE Primary

Addresses

Primary practice location

9239 W Center Rd
Suite 103
Omaha, NE 68124-1933

Mailing address

9239 W Center Rd
Suite 103
Omaha, NE 68124-1933
Phone (402) 898-3232

Other identifiers 5

IdentifierTypeStateIssuer
1151289MedicaidLA
0432161MedicaidIA
7100151470MedicaidKY
2029544MedicaidWA
G20027930AMedicaidOK

National Provider Directory

National Provider Directory

Locations

8016 SE 15th St
Oklahoma City, OK 73110
Phone (405) 737-5685

Practitioners & affiliated clinicians

Practitioners 6

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": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300838400000",
    "number": "1598714008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9239 W CENTER RD",
            "address_2": "SUITE 103",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681241933",
            "telephone_number": "402-898-3232",
            "fax_number": "402-898-3234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9239 W CENTER RD",
            "address_2": "SUITE 103",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681241933",
            "telephone_number": "402-898-3232",
            "fax_number": "402-898-3234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYNDON GRAVES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2011-03-23",
        "status": "A",
        "authorized_official_last_name": "GRAVES",
        "authorized_official_first_name": "LYNDON",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "402-898-3232",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NE",
            "license": "998",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1151289",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0432161",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100151470",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2029544",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G20027930A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.