Organization Active NPI

James R. Pace, O.D., P.a.

  • Optometrist
  • Wichita, KS
National Provider Identifier
1760654800
Registry record updated Sep 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
972-3 Issued in KS
Legal business name
JAMES R. PACE, O.D., P.A.
Practice address
1039 N Broadway St
Wichita, KS 67214-2906
Phone
(316) 262-8476
Fax
(316) 262-8477
NPI assigned
Mar 28, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2011

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

Authorized official

Name
Mr. James Rex Pace, O.D.
Title
Propriator
Phone
(316) 262-8476

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 972-3 KS Primary

Addresses

Primary practice location

1039 N Broadway St
Wichita, KS 67214-2906

Mailing address

1039 N Broadway St
Wichita, KS 67214-2906
Phone (316) 262-8476

Other identifiers 5

IdentifierTypeStateIssuer
410044812OtherKSRAILROAD MEDICARE
63197OtherKSMISSOURI PACIFIC TRAVELER
4083937OtherKSAETNA
100090590BMedicaidKS
650799OtherKSBLUECROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Locations

1039 N Broadway Ave
Wichita, KS 67214
Phone (316) 262-8476

NPI Registry JSON

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

{
    "created_epoch": "1206662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317340800000",
    "number": "1760654800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1039 N BROADWAY ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672142906",
            "telephone_number": "316-262-8476",
            "fax_number": "316-262-8477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1039 N BROADWAY ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672142906",
            "telephone_number": "316-262-8476",
            "fax_number": "316-262-8477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES R. PACE, O.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-28",
        "last_updated": "2011-09-30",
        "status": "A",
        "authorized_official_last_name": "PACE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "REX",
        "authorized_official_title_or_position": "PROPRIATOR",
        "authorized_official_telephone_number": "316-262-8476",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "KS",
            "license": "972-3",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410044812",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSOURI PACIFIC TRAVELER",
            "identifier": "63197",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4083937",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100090590B",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUE SHIELD",
            "identifier": "650799",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2011; 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.