Active NPI
Kim A Baxter, OD
- Optometrist
- North Platte, NE
National Provider Identifier
1750348280
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 854
- Practice address
- 111 S Bailey Ave
North Platte, NE 69101-5404 - Phone
- (308) 534-2000
- Fax
- (308) 534-2001
- NPI assigned
- Apr 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 854 | NE | Primary |
Addresses
Primary practice location
111 S Bailey Ave
North Platte, NE 69101-5404
Mailing address
111 S Bailey Ave
North Platte, NE 69101-5404
Phone (308) 534-2000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 47054418213 | Medicaid | NE | |
| 6784 | Other | NE | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 854 | NE | MD | Mental Health Counselor |
Interoperability endpoints
- kbaxter@completeeyecareassociates.emadirect.md
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1360195200000",
"number": "1750348280",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 S BAILEY AVE",
"city": "NORTH PLATTE",
"state": "NE",
"postal_code": "691015404",
"telephone_number": "308-534-2000",
"fax_number": "308-534-2001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 S BAILEY AVE",
"city": "NORTH PLATTE",
"state": "NE",
"postal_code": "691015404",
"telephone_number": "308-534-2000",
"fax_number": "308-534-2001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAXTER",
"first_name": "KIM",
"middle_name": "A",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-27",
"last_updated": "2013-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NE",
"license": "854",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "47054418213",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "6784",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in North Platte, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.