Individual provider Active NPI

Nick D Banks, OD

  • Optometrist
  • Fayetteville, AR
National Provider Identifier
1861476707
Registry record updated Dec 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2007 Issued in AR
Practice address
2901 E Zion Rd
Ste 4
Fayetteville, AR 72703-5007
Phone
(479) 443-2025
Fax
(479) 443-2032
NPI assigned
Dec 5, 2005
Last updated
Dec 8, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2007 AR Primary

Addresses

Primary practice location

2901 E Zion Rd
Ste 4
Fayetteville, AR 72703-5007

Mailing address

2901 E Zion Rd
Ste 4
Fayetteville, AR 72703-5007
Phone (479) 443-2025

Other identifiers 6

IdentifierTypeStateIssuer
263122083OtherARTAX ID
106310722MedicaidAR
410038411OtherRAILROAD MEDICARE
710814666OtherTID
47968OtherARARKANSAS BCBS
BA700418OtherHIGHMARK BCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081029000751 AR Practitioner - Optometry 3971662362 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dang Eyecare and Associates, P.a.Group PAC ID 2365599610, 11 clinicians

Practice addresses (Care Compare)

2600 W Pleasant Crossing Dr
Suite 60
Rogers, AR 72758-8323
Phone (479) 202-4725

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2007ARMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Jeffries Eye Clinic PA Optometrist CurrentSince Jun 5, 2013 Accepting new patients
Banks Family Eye Clinic PLLC Optometrist CurrentSince Nov 4, 1998 Accepting new patients
Martha Ellen Myers, O.D. PA Optometrist CurrentSince Nov 8, 2018 Accepting new patients
Dang Eyecare & Associates, P.a. Optometrist CurrentSince Aug 29, 2023 Accepting new patients

Locations

2875 W Martin Luther King Jr Blvd
Fayetteville, AR 72704
Phone (479) 521-4350

2901 E Zion Rd
Ste 4
Fayetteville, AR 72703
Phone (479) 443-2025

4189 Phoenix Ave
Ste B
Fort Smith, AR 72903
Phone (479) 434-4668

2600 W Pleasant Crossing Dr
Ste 60
Rogers, AR 72758
Phone (479) 202-4725

3602 W Southern Hills Blvd
Rogers, AR 72758
Phone (479) 631-8900

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 6

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": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228694400000",
    "number": "1861476707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 E ZION RD",
            "address_2": "STE 4",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727035007",
            "telephone_number": "479-443-2025",
            "fax_number": "479-443-2032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 E ZION RD",
            "address_2": "STE 4",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727035007",
            "telephone_number": "479-443-2025",
            "fax_number": "479-443-2032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANKS",
        "first_name": "NICK",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-05",
        "last_updated": "2008-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "263122083",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106310722",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410038411",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TID",
            "identifier": "710814666",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARKANSAS BCBS",
            "identifier": "47968",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BCBS",
            "identifier": "BA700418",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.