Individual provider Active NPI

Nicole Renee Miller, O.D.

  • Optometrist
  • Great Bend, KS
National Provider Identifier
1700225299
Registry record updated Jun 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1948 Issued in KS
Practice address
2601 10TH St
Great Bend, KS 67530-4253
Phone
(620) 792-2020
NPI assigned
Jun 18, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1948 KS Primary

Addresses

Primary practice location

2601 10TH St
Great Bend, KS 67530-4253

Mailing address

PO Box 23
Claflin, KS 67525-0023
Phone (620) 617-2098

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20130725000805 KS Practitioner - Optometry 8022259530 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McCaulley Optometric PAGroup PAC ID 9638134315, 4 clinicians

Practice addresses (Care Compare)

2601 10TH St
Great Bend, KS 67530-4253
Phone (620) 792-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery20

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
McCaulley Optometric PA Optometrist CurrentSince Aug 1, 2013 Accepting new patients
The Russell Eyecare Center Optometrist CurrentSince Aug 20, 2017 Accepting new patients

Locations

2601 10th St
Great Bend, KS 67530
Phone (620) 792-2020

702 N Kansas St
Russell, KS 67665
Phone (785) 483-2451

Organizations & group practices 2

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": "1371513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371513600000",
    "number": "1700225299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23",
            "city": "CLAFLIN",
            "state": "KS",
            "postal_code": "675250023",
            "telephone_number": "620-617-2098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 10TH ST",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "675304253",
            "telephone_number": "620-792-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "NICOLE",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-18",
        "last_updated": "2013-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Bend, KS

Sources for this page

Verify at the official NPI Registry.