Ruth Nicolas, OD, PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

A125 Issued in AK

Legal business name

RUTH NICOLAS, OD, PC

Practice address

570 Riverstone Way
Ste 3
Fairbanks, AK 99709-2939

Phone

(907) 479-4700

Fax

(907) 457-5596

NPI assigned

Mar 18, 2008

Last updated

Mar 18, 2008By 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

Ruth Nicolas, OD, PC

Title

President

Phone

(907) 479-4700

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1205798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205798400000",
    "number": "1760653778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 RIVERSTONE WAY",
            "address_2": "STE 3",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997092939",
            "telephone_number": "907-479-4700",
            "fax_number": "907-457-5596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 RIVERSTONE WAY",
            "address_2": "STE 3",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997092939",
            "telephone_number": "907-479-4700",
            "fax_number": "907-457-5596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUTH NICOLAS, OD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-18",
        "last_updated": "2008-03-18",
        "status": "A",
        "authorized_official_last_name": "NICOLAS",
        "authorized_official_first_name": "RUTH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "907-479-4700",
        "authorized_official_credential": "OD, PC"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AK",
            "license": "A125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OD01251",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Optometrist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2008; 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.