NPIMap

Organization Active NPI

Statton Optical

  • Eyewear Supplier
  • Lincoln, NE
National Provider Identifier
1679921720
Registry record updated May 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
ABOC 081991 Issued in NE
Legal business name
STATTON OPTICAL
Practice address
4645 Normal Blvd Ste 132
Lincoln, NE 68506-5823
Phone
(402) 486-4828
NPI assigned
May 31, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2016

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

Authorized official

Name
Mr. Stephen A Statton, ABOC
Title
Optician
Phone
(402) 486-4828

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X ABOC 081991 NE Primary

Addresses

Primary practice location

4645 Normal Blvd Ste 132
Lincoln, NE 68506-5823

Mailing address

4645 Normal Blvd Ste 132
Lincoln, NE 68506-5823
Phone (402) 486-4828

Other identifiers 2

IdentifierTypeStateIssuer
10026128600MedicaidNE
6549480001OtherNEMEDICARE PTAN

National Provider Directory

National Provider Directory

Locations

4645 Normal Blvd
Ste 132
Lincoln, NE 68506
Phone (402) 486-4828

NPI Registry JSON

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

{
    "created_epoch": "1464652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464652800000",
    "number": "1679921720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4645 NORMAL BLVD STE 132",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685065823",
            "telephone_number": "402-486-4828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4645 NORMAL BLVD STE 132",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685065823",
            "telephone_number": "402-486-4828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATTON OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-31",
        "last_updated": "2016-05-31",
        "status": "A",
        "authorized_official_last_name": "STATTON",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OPTICIAN",
        "authorized_official_telephone_number": "402-486-4828",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ABOC"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NE",
            "license": "ABOC 081991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026128600",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "6549480001",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2016; 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.