Individual provider Active NPI

Kathy Ann Niemann, OPTICIAN

  • Optician
  • Omaha, NE
National Provider Identifier
1790073120
Registry record updated Sep 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
Practice address
1104 S 76TH Ave
Omaha, NE 68124-1559
Phone
(402) 955-2020
Fax
(402) 955-2025
NPI assigned
Jul 19, 2011
Last updated
Sep 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X Primary

Addresses

Primary practice location

1104 S 76TH Ave
Omaha, NE 68124-1559

Mailing address

1104 S 76TH Ave
Omaha, NE 68124-1559
Phone (402) 955-2020

Other identifiers 1

IdentifierTypeStateIssuer
100-25-2246-00MedicaidNE

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)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kyle Niemann, O.D., P.C. Optician CurrentSince Sep 24, 2023 Accepting new patients
Kate E Hansen DC PC CurrentSince Sep 24, 2023 Accepting new patients
Visual Eyes Optical Optician Past Accepting new patients

Locations

1104 S 76th Ave
Omaha, NE 68124
Phone (402) 933-7944

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1311033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1790073120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 S 76TH AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681241559",
            "telephone_number": "402-955-2020",
            "fax_number": "402-955-2025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 S 76TH AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681241559",
            "telephone_number": "402-955-2020",
            "fax_number": "402-955-2025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEMANN",
        "first_name": "KATHY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "OPTICIAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-19",
        "last_updated": "2023-09-21",
        "certification_date": "2022-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100-25-2246-00",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2023; 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.