Individual provider Active NPI

Katelyn Keefer, OD

  • Optometrist
  • Omaha, NE
National Provider Identifier
1972125904
Registry record updated Jan 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1562 Issued in NE
Practice address
16016 Evans St Ste 101
Omaha, NE 68116-6457
Phone
(402) 493-3224
NPI assigned
May 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 030.0133923-EMGY VT
Optometrist 152W00000X 030.0133929 VT
Optometrist 152W00000X 1012 NH
Optometrist 152W00000X 1562 NE Primary

Addresses

Primary practice location

16016 Evans St Ste 101
Omaha, NE 68116-6457

Mailing address

111 E 4TH St Ste 440
Alton, IL 62002-6241
Phone (618) 462-9818

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, IA2 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
I20220314000103 NE Practitioner - Optometry 4284055997 Reassigns benefits to 4 organizations
I20240601000504 IA Practitioner - Optometry 4284055997 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2020
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 surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1562NEMDOptometrist
1012NHMDOptometrist
030.0133929VTMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Specialists of Omaha LLC Optometrist CurrentSince May 8, 2024 Accepting new patients
Vision Specialists of Council Bluffs LLC Optometrist CurrentSince May 8, 2024 Accepting new patients
Vision Specialists of Papillion LLC Optometrist CurrentSince May 8, 2024 Accepting new patients
John H McDougall OD PC Optometrist CurrentSince Jan 31, 2022 Accepting new patients
John H McDougall OD PC Optometrist CurrentSince Jan 31, 2022 Accepting new patients

Locations

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

111 E 4th St
Ste 440
Alton, IL 62002

2005 Court St
Beatrice, NE 68310
Phone (402) 223-4098

2500 Northview Rd
Lincoln, NE 68521
Phone (402) 420-2020

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

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1589328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642723200000",
    "number": "1972125904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E 4TH ST STE 440",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026241",
            "telephone_number": "618-462-9818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16016 EVANS ST STE 101",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681166457",
            "telephone_number": "402-493-3224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEEFER",
        "first_name": "KATELYN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-13",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VT",
            "license": "030.0133923-EMGY",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VT",
            "license": "030.0133929",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NH",
            "license": "1012",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NE",
            "license": "1562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.