Individual provider Active NPI

Kristi Marie Merchant, OD

  • Optometrist
  • Harlan, IA
National Provider Identifier
1669213666
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
126785 Issued in IA
Practice address
620 Market St
Harlan, IA 51537-1412
Phone
(712) 755-2020
NPI assigned
Jun 4, 2024
Last updated
Jun 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 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 126785 IA Primary

Addresses

Primary practice location

620 Market St
Harlan, IA 51537-1412

Mailing address

105 Gaul Dr
Sergeant Bluff, IA 51054-8973
Phone (712) 943-9400

Other practice location 1

105 Gaul Dr
Sergeant Bluff, IA 51054-8973
Phone (712) 943-9400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240722000801 IA Practitioner - Optometry 9931645488 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hawkeye Clinic of Sergeant Bluff PCGroup PAC ID 6709978349, 4 clinicians
Harlan Eye Care PCGroup PAC ID 5193122729, 2 clinicians

Practice addresses (Care Compare)

105 Gaul Dr
Sergeant Bluff, IA 51054-8963

712 Durant St
Harlan, IA 51537-1621
Phone (712) 755-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
126785IAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Jays Family Eye Care LLC Optometrist CurrentSince Jun 9, 2024 Accepting new patients
Hawkeye Clinic of Sergeant Bluff, PC Optometrist CurrentSince Aug 1, 2024 Accepting new patients
Harlan Eye Care PC Optometrist CurrentSince Aug 1, 2024 Accepting new patients

Locations

620 Market St
Harlan, IA 51537
Phone (712) 755-2020

712 Durant St
Harlan, IA 51537
Phone (712) 755-2020

105 Gaul Dr
Sergeant Bluff, IA 51054
Phone (712) 490-4658

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1717459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1669213666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 GAUL DR",
            "city": "SERGEANT BLUFF",
            "state": "IA",
            "postal_code": "510548973",
            "telephone_number": "712-943-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 MARKET ST",
            "city": "HARLAN",
            "state": "IA",
            "postal_code": "515371412",
            "telephone_number": "712-755-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 Gaul Dr",
            "address_purpose": "LOCATION",
            "city": "Sergeant Bluff",
            "state": "IA",
            "postal_code": "510548973",
            "country_code": "US",
            "telephone_number": "712-943-9400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MERCHANT",
        "first_name": "KRISTI",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-04",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "126785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harlan, IA

Sources for this page

Verify at the official NPI Registry.