Mandy O.D., P.C.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1220 Issued in NE

Legal business name

MANDY O.D., P.C.

Doing business as

Optical Gallery

Practice address

220 W 39TH St
Kearney, NE 68845-2802

Phone

(308) 234-9913

Fax

(308) 234-4006

NPI assigned

Oct 24, 2007

Last updated

Nov 12, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mandy Jane JohnsonNPI 1679539274

Title

Owner/Optometrist

Phone

(308) 234-9913

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Optical Gallery Doing business as

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

Locations

Practitioners 5

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.

• Mandy Jane Johnson, OD

  • Optometrist
  • Kearney, NE
  • NPI 1679539274
  Medicare reassignment Care Compare group NPD Authorized official
• Katherine Helen Fleecs, OD

  • Optometrist
  • Kearney, NE
  • NPI 1497245948
  Medicare reassignment Care Compare group NPD
• Erin C Graff, O.D.

  • Optometrist
  • Hastings, NE
  • NPI 1134569155
  Medicare reassignment NPD
• Dennis P Sherrerd, OD

  • Optometrist
  • Kearney, NE
  • NPI 1073571659
  NPD (past)
• Krista K Tonniges, O.D.

  • Optometrist
  • North Platte, NE
  • NPI 1558593384
  NPD (past)

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

{
    "created_epoch": "1193184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636675200000",
    "number": "1710166996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5403 N AVE",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688478514",
            "telephone_number": "308-234-9133",
            "fax_number": "308-234-4006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 W 39TH ST",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688452802",
            "telephone_number": "308-234-9913",
            "fax_number": "308-234-4006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANDY O.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-24",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-12",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MANDY",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "308-234-9913"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NE",
            "license": "1220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025556000",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "37173",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optical Gallery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Optical Gallery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rita Marie Maloley, LCSW
• Sadie Maloley
• Samantha Ann Malone
• Stacy Marie Malone
• Mandy Meyer Counseling, L.L.C.
• Kathryn L. Manley, LMHP
• Nicholas Thomas Mansuetta, D.O.
• Jolyn Mapes
• Maple Mental Health, LLC
• Marathon Health, Inc.

• Optometrist in Kearney, NE
• Providers in Kearney, NE by specialty
• Optometrist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2021; 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.