Richard Lane Nutt, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

T02491 Issued in MO

Practice address

1111 E Cambridge St
Bolivar, MO 65613-3500

Phone

(417) 326-6001

NPI assigned

Dec 27, 2005

Last updated

Oct 26, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 MO

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

Illinois College of Optometry at Chicago, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bolivar Vision, LLCGroup PAC ID 6608190152, 4 clinicians

El Dorado Vision LLCGroup PAC ID 0547501041, 2 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.

• Bolivar Vision, LLC

  dba Vision Source Bolivar

  • Optometrist
  • Bolivar, MO
  • NPI 1578969960
  Medicare reassignment Care Compare group NPD
• El Dorado Vision LLC

  dba Vision Source El Dorado Springs

  • Optometrist
  • El Dorado Springs, MO
  • NPI 1902379266
  Medicare reassignment Care Compare group NPD
• Orchard Eye Clinic LLC

  dba Orchard Eye Clinic

  • Optometrist
  • Bolivar, MO
  • NPI 1093553182
  NPD
• Missouri Eye Institute LLC

  • Ophthalmology Physician
  • Springfield, MO
  • NPI 1144277252

  Optometrist

  NPD (past)

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

{
    "created_epoch": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1710964309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 E CAMBRIDGE ST",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656133500",
            "telephone_number": "417-326-6001",
            "fax_number": "417-326-6002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 E CAMBRIDGE ST",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656133500",
            "telephone_number": "417-326-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUTT",
        "first_name": "RICHARD",
        "middle_name": "LANE",
        "name_prefix": "Mr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-27",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T02491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710964309",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Leigh A O'Connor, PA-C
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• Oasis Counseling and Education, LLC
• Sonja Lynn Obryan, PHARM D
• Janet Amoakoah Ofori-Yeboah, NP-C

• Optometrist in Bolivar, MO
• Providers in Bolivar, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2020; 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.