Thomas Keith Boan, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1537 Issued in NC

Practice address

1060 Lenoir Rhyne Blvd SE
Hickory, NC 28602-4330

Phone

(828) 328-3900

Fax

(828) 328-5253

NPI assigned

Aug 9, 2005

Last updated

Jul 24, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Optometry

Education

University Alabama Birmingham - School of Optometry, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clark Optometric Center PAGroup PAC ID 6709911092, 45 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Clark Optometric Center PA

  dba Triangle Visions Optometry

  • Optometrist
  • Durham, NC
  • NPI 1588619217
  Medicare reassignment Care Compare group NPD
• Eyecarecenter, O.D., P.a.

  dba EyeCare Center

  • Optometrist
  • Fayetteville, NC
  • NPI 1336876788
  NPD (past)

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216857600000",
    "number": "1699776096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1060 LENOIR RHYNE BLVD SE",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286024330",
            "telephone_number": "828-328-3900",
            "fax_number": "828-328-5253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 LENOIR RHYNE BLVD SE",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286024330",
            "telephone_number": "828-328-3900",
            "fax_number": "828-328-5253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOAN",
        "first_name": "THOMAS",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2008-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1537",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890906M",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chelsea Blevins
• Joshua James Blevins, MSOT, OTRL
• Blue Ridge Healthcare Medical Group Inc (Blue Ridge Radiology)
• Blue Ridge Healthcare Medical Group, Inc. (Women's Health Group-Hickory)
• India M. Blue, P.A.
• Abigail Boehm
• Jason Boehme I, DC
• Todd Michael Bohemier, PT/L
• Rachel Boisvert, DPT
• Yosheta Teasley Bolder, FNP-C

• Optometrist in Hickory, NC
• Providers in Hickory, NC by specialty
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.