NPIMap

Organization Active NPI

Premier Eye Care and Contact Lens Services, PC

  • Optometrist
  • Kearney, NE
National Provider Identifier
1699062828
Registry record updated Oct 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1325 Issued in NE
Legal business name
PREMIER EYE CARE AND CONTACT LENS SERVICES, PC
Practice address
920 E 56TH St
D3
Kearney, NE 68847-8628
Phone
(308) 455-1283
Fax
(308) 455-1285
NPI assigned
Jul 8, 2011
Last updated
Oct 19, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2011

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

Authorized official

Name
Dr. Michael Kelly Gilbreath, ODNPI 1942438650
Title
Optometrist
Phone
(402) 661-9033

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 1325 NE Primary

Addresses

Primary practice location

920 E 56TH St
D3
Kearney, NE 68847-8628

Mailing address

920 E 56TH St
D3
Kearney, NE 68847-8628
Phone (308) 455-1283

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111019000087 NE Part B Supplier - Clinic/Group Practice 2062684913 Receives reassigned benefits from 1 practitioner
Practice locations: Kearney, NE

National Provider Directory

National Provider Directory

Locations

218 W 42nd St
Kearney, NE 68845
Phone (308) 237-9633

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": "1310083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318982400000",
    "number": "1699062828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 E 56TH ST",
            "address_2": "D3",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688478628",
            "telephone_number": "308-455-1283",
            "fax_number": "308-455-1285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 E 56TH ST",
            "address_2": "D3",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688478628",
            "telephone_number": "308-455-1283",
            "fax_number": "308-455-1285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER EYE CARE AND CONTACT LENS SERVICES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-08",
        "last_updated": "2011-10-19",
        "status": "A",
        "authorized_official_last_name": "GILBREATH",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "KELLY",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "402-661-9033",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NE",
            "license": "1325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kearney, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.