Wyatt Nash-Keller OD Prof LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

723 Issued in SD

Legal business name

WYATT NASH-KELLER OD PROF LLC

Practice address

960 22ND Ave S
Brookings, SD 57006-2830

Phone

(605) 370-6066

NPI assigned

Feb 16, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Wyatt Nash-Keller, O.D.NPI 1124371992

Title

Optometrist

Phone

(605) 370-6066

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Wyatt Nash-Keller, O.D.

  • Optometrist
  • Brookings, SD
  • NPI 1124371992
  NPD (past) Authorized official
• Richard George Barnett, O.D.

  • Optometrist
  • Sioux Falls, SD
  • NPI 1730244567
  NPD (past)

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

{
    "created_epoch": "1455580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455580800000",
    "number": "1730548975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 22ND AVE S",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570062830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 22ND AVE S",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570062830",
            "telephone_number": "605-370-6066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYATT NASH-KELLER OD PROF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-16",
        "last_updated": "2016-02-16",
        "status": "A",
        "authorized_official_last_name": "NASH-KELLER",
        "authorized_official_first_name": "WYATT",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "605-370-6066",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "SD",
            "license": "723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124371992",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brooke Madison Wilmesherr, CCC-SLP
• Wiseman & Tidstrom Dental Management, LLC
• Erik Mark Treman Wiseman, DDS
• Bradley D. Woldt, PH.D.
• Blake Wooten
• Christina Yackley, DC
• Yorkshire Eye Clinic,LTD
• Mary Beth Zwart, ATC

• Optometrist in Brookings, SD
• Providers in Brookings, SD by specialty
• Optometrist in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2016; 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.