Jeremy M. Fast, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2004020666 Issued in MO

Practice address

111 N Main St
Nevada, MO 64772-2330

Phone

(417) 667-3076

NPI assigned

Mar 1, 2007

Sex

Male

Sole proprietor

Yes

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Eyecare Professionals, Inc

  • Optometrist
  • Nevada, MO
  • NPI 1891820122

  MO

  Medicare reassignment Care Compare group
• Mid America Eye Center PA

  • Ophthalmology Physician
  • Prairie Village, KS
  • NPI 1215967229

  Optometrist

  NPD (past)

Specialty

Optometry

Education

University of Missouri St Louis - School of Optometry, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eyecare Professionals Inc 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730217795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N MAIN ST",
            "city": "NEVADA",
            "state": "MO",
            "postal_code": "647722330",
            "telephone_number": "417-667-3076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N MAIN ST",
            "city": "NEVADA",
            "state": "MO",
            "postal_code": "647722330",
            "telephone_number": "417-667-3076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAST",
        "first_name": "JEREMY",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2004020666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "319152005",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kevin Joseph Ewing, LPC
• Eyecare Professionals, Inc
• Anna Farmer, CRADC
• Bethany K Fast, FNP-C, PMHNP-BC
• Delton L Fast, OD
• John Fox, M.D.
• Roger A Francis, MD
• Alexander Franks, PLPC
• Michael G Freeze Sr., MAADC
• Friendship House

• All providers in Nevada, MO
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.