Individual provider Active NPI

Nichole Lauren Banfield, O.D.

  • Optometrist
  • Milwaukee, WI
National Provider Identifier
1609560432
Registry record updated Jun 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT-002730 Issued in AZ
Practice address
4101 N 56TH St
Milwaukee, WI 53216-1267
Phone
(414) 447-9403
NPI assigned
Jun 5, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT-002730 AZ Primary

Addresses

Primary practice location

4101 N 56TH St
Milwaukee, WI 53216-1267

Mailing address

2008 N 50TH Dr
Phoenix, AZ 85035-3925

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OPT-002730AZMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
National Vision Inc Optometrist PastSince Jun 1, 2023 Accepting new patients
America'S Best Contacts & Eyeglasses PastSince Jun 9, 2024 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1685923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717718400000",
    "number": "1609560432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2008 N 50TH DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850353925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 N 56TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532161267",
            "telephone_number": "414-447-9403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANFIELD",
        "first_name": "NICHOLE",
        "middle_name": "LAUREN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-05",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "OPT-002730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2024; 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.