Stacie R. Nichols, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD00003248 Issued in WA

Practice address

506 8TH St.
Davenport, WA 99122

Phone

(509) 725-2000

Fax

(509) 725-4231

NPI assigned

Jul 19, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Optometry

Education

Pacific University - College of Optometry, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as individual

Quality

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Davenport Vision Clinic, Inc.

  • Optometrist
  • Davenport, WA
  • NPI 1447323811
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270080000000",
    "number": "1912927518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27",
            "city": "DAVENPORT",
            "state": "WA",
            "postal_code": "991220027",
            "telephone_number": "509-725-2000",
            "fax_number": "509-725-4231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 8TH ST.",
            "city": "DAVENPORT",
            "state": "WA",
            "postal_code": "99122",
            "telephone_number": "509-725-2000",
            "fax_number": "509-725-4231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "STACIE",
        "middle_name": "R.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2010-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00003248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2025815",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jason K McCauley, PHARM.D.
• Christopher Richard McCowan, PHARM. D
• Darby Merritt, LM, CPM
• Melissa Ann Michaud, BSN-RN
• Chad A Mongrain, DO
• Trea Nonnemacher, RN
• Karl H Olson, MD
• Nina Mayer Olson, COTA/L
• Leah Olvera
• Rolf K Panke, DO

• Optometrist in Davenport, WA
• Providers in Davenport, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.