Individual provider Active NPI

Jordan Frederick Keith, O.D.

  • Optometrist
  • Omaha, NE
National Provider Identifier
1861646937
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1589 Issued in NE
Practice address
3606 N 156TH St
Omaha, NE 68116-2158
Phone
(402) 205-0754
NPI assigned
Nov 15, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3153 MN
Optometrist 152W00000X 1589 NE Primary
Optometrist 152W00000X 116516 IA

Addresses

Primary practice location

3606 N 156TH St
Omaha, NE 68116-2158

Mailing address

3606 N 156TH St Ste 105
Omaha, NE 68116-2163
Phone (402) 205-0754

Other practice location 1

2514 W Broadway
Council Bluffs, IA 51501-3509
Phone (712) 322-3097

Other practice location 2

120 Olson Dr Ste 107
Papillion, NE 68046-2961
Phone (402) 504-4257

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, NE2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220923001449 IA Practitioner - Optometry 7618014952 Reassigns benefits to 1 organization
I20221018001896 NE Practitioner - Optometry 7618014952 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vision Specialists of Papillion LLCGroup PAC ID 8729320411, 6 clinicians
Vision Specialists of Council Bluffs LLCGroup PAC ID 4183793938, 6 clinicians
Vision Specialists of Omaha LLCGroup PAC ID 7719212307, 4 clinicians

Practice addresses (Care Compare)

120 Olson Dr
Suite 107
Papillion, NE 68046-2961
Phone (402) 897-6375

2514 W Broadway
Council Bluffs, IA 51501-3509
Phone (712) 322-3097

3606 N 156TH St
Suite 105
Omaha, NE 68116-2163
Phone (402) 205-0754

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3153MNMDMental Health Counselor
116516IAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Specialists of Omaha LLC Optometrist CurrentSince Jan 5, 2023 Accepting new patients
Vision Specialists of Council Bluffs LLC Optometrist CurrentSince Sep 9, 2022 Accepting new patients

Locations

2514 W Broadway
Council Bluffs, IA 51501
Phone (712) 227-6340

3606 N 156th St
Ste 105
Omaha, NE 68116
Phone (402) 205-0754

3606 N 156th St
Ste 104
Omaha, NE 68116
Phone (402) 205-0754

3606 N 156th St
Omaha, NE 68116
Phone (402) 205-0754

120 Olson Dr
Ste 107
Papillion, NE 68046
Phone (402) 504-4257

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1226707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1861646937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3606 N 156TH ST STE 105",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681162163",
            "telephone_number": "402-205-0754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3606 N 156TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681162158",
            "telephone_number": "402-205-0754"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2514 W Broadway",
            "address_purpose": "LOCATION",
            "city": "Council Bluffs",
            "state": "IA",
            "postal_code": "515013509",
            "country_code": "US",
            "telephone_number": "712-322-3097",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "120 Olson Dr Ste 107",
            "address_purpose": "LOCATION",
            "city": "Papillion",
            "state": "NE",
            "postal_code": "680462961",
            "country_code": "US",
            "telephone_number": "402-504-4257",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEITH",
        "first_name": "JORDAN",
        "middle_name": "FREDERICK",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-15",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3153",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NE",
            "license": "1589",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "116516",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.