NPIMap

Organization Active NPI

Kister Eyecare, PC

  • Optometrist
  • Riverton, WY
National Provider Identifier
1700055951
Registry record updated Dec 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
115T Issued in WY
Legal business name
KISTER EYECARE, PC
Practice address
400 E Adams Ave
Riverton, WY 82501-4413
Phone
(307) 856-6531
Fax
(307) 856-1306
NPI assigned
Feb 21, 2008
Last updated
Dec 7, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2012

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

Authorized official

Name
Dr. Benjamin J. Kister, O.D.NPI 1336125319
Title
Doctor, Owner
Phone
(307) 856-6531

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 115T WY Primary

Addresses

Primary practice location

400 E Adams Ave
Riverton, WY 82501-4413

Mailing address

400 E Adams Ave
Riverton, WY 82501-4413
Phone (307) 856-6531

Other identifiers 3

IdentifierTypeStateIssuer
104032400MedicaidWY
4590585OtherWYMEDICARE
1897-001OtherWYBCBS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1203552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354838400000",
    "number": "1700055951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E ADAMS AVE",
            "city": "RIVERTON",
            "state": "WY",
            "postal_code": "825014413",
            "telephone_number": "307-856-6531",
            "fax_number": "307-856-1306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E ADAMS AVE",
            "city": "RIVERTON",
            "state": "WY",
            "postal_code": "825014413",
            "telephone_number": "307-856-6531",
            "fax_number": "307-856-1306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KISTER EYECARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-21",
        "last_updated": "2012-12-07",
        "status": "A",
        "authorized_official_last_name": "KISTER",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "DOCTOR, OWNER",
        "authorized_official_telephone_number": "307-856-6531",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WY",
            "license": "115T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104032400",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "4590585",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1897-001",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverton, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2012; 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.