Daniel E Boone OD
Organization Active NPI Optometrist · Nixa, MO
NPI 1891730388 · NPPES record last updated Jul 7, 2025
Key facts
- NPI
- 1891730388
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- T03007 (MO)
- Legal business name
- DANIEL E BOONE OD
- Practice address
- 107 Village Center St
Nixa, MO 65714-7824 - Phone
- (417) 725-0000
- Fax
- (417) 725-0002
- NPI assigned
- Jun 18, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Daniel E. Boone, O.D.
- Title
- Owner/Optometrist
- Phone
- (417) 725-0000
Practitioners 2
-
Daniel E Boone, O.D.
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Nixa Family Eye Care |
Prosthetic Lenses: Conventional Eyeglasses | Accepts assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250722004181 | MO | Part B Supplier - Clinic/Group Practice | 2466975651 |
Receives reassigned benefits from 2 practitioners Practice locations: Nixa, MO |
| O20260320003442 | MO | DME Supplier - Physician - Optometrist | 2466975651 | Practice locations: Nixa, MO |
National Provider Directory
Locations
107 Village Center St
Nixa, MO 65714
Phone (417) 725-0000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | T03007 | MO | Yes |
Addresses
Primary practice location
107 Village Center St
Nixa, MO 65714-7824
Mailing address
107 Village Center St
Nixa, MO 65714-7824
Phone (417) 725-0000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5075511202 | Medicaid | MO |
Other names
- NIXA FAMILY EYE CARE
Other providers in Nixa, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 7, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.