NPIMap

Organization Active NPI

Nickel OD, LLC

  • Optometrist
  • Cedar Rapids, IA
National Provider Identifier
1962780726
Registry record updated Jul 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
002519 Issued in IA
Legal business name
NICKEL OD, LLC
Practice address
1030 Blairs Ferry Rd NE
Cedar Rapids, IA 52402-1220
Phone
(319) 393-4459
NPI assigned
Jul 28, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2011

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

Authorized official

Name
Dr. Annette NickelNPI 1053607093
Title
Owner
Phone
(740) 262-6857

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 002519 IA Primary

Addresses

Primary practice location

1030 Blairs Ferry Rd NE
Cedar Rapids, IA 52402-1220

Mailing address

208 Sunflower Dr
Fairfax, IA 52228-4731

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1311811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311811200000",
    "number": "1962780726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 SUNFLOWER DR",
            "city": "FAIRFAX",
            "state": "IA",
            "postal_code": "522284731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 BLAIRS FERRY RD NE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524021220",
            "telephone_number": "319-393-4459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICKEL OD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-28",
        "last_updated": "2011-07-28",
        "status": "A",
        "authorized_official_last_name": "NICKEL",
        "authorized_official_first_name": "ANNETTE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "740-262-6857",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IA",
            "license": "002519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2011; 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.