WYATT NASH-KELLER OD PROF LLC (NPI# 1730548975) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730548975 |
| Entity Type | Organization |
| Organization Name | WYATT NASH-KELLER OD PROF LLC |
| Practice Address |
960 22nd Ave S Brookings SD 57006-2830 |
| Practice Telephone | 6053706066 |
| Enumeration Date | 2016-02-16 |
| Last Update Date | 2016-02-16 |
| Authorized Official Name | DR. WYATT NASH-KELLER (OPTOMETRIST) |
| Authorized Official Telephone | 6053706066 |
| Authorized Official Credential | O.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 723 | SD | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SD | 1124371992 | 05 |
| Street Address |
960 22ND AVE S |
| City | BROOKINGS |
| State | SD |
| Zip Code | 57006-2830 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720685845 | Leah Kroeger | Specialist/Technologist | 2820 Stanley J Marshall Center, Brookings, SD 57006 | 2020-10-01 |
| 1619454774 | Alec Edward Weis | Student in an Organized Health Care Education/Training Program | 314 Main Ave Apt 4., Brookings, SD 57006 | 2018-07-22 |
| 1629569066 | Robin Lynn Erz | Counselor | East Central Behavioral Health, 211 4th Street, Brookings, SD 57006 | 2018-05-22 |
| 1982057246 | City of Brookings | Clinic/Center | 310 22nd Avenue, Brookings, SD 57006 | 2016-07-21 |
| 1922413806 | Avera Mckennan | Clinic/Center | 400 2nd Ave, Brookings, SD 57006 | 2014-06-30 |
| 1093157554 | Nathan William Hilbrands | Dentist | 427 8th St S, Brookings, SD 57006 | 2013-07-25 |
| 1992073951 | Andrea Uckert | Counselor | 619 5th Ave Ste 3, Brookings, SD 57006 | 2011-12-06 |
| 1972800100 | Melissa Ann Klemm | Counselor | 1304 Main Ave S, Brookings, SD 57006 | 2011-02-24 |
| 1285873539 | Amy Lynn Osterberg | Counselor | 211 4th St., East Central Mh/cd Center Inc, Brookings, SD 57006 | 2009-02-10 |
| 1114062072 | Kendalls Rexall Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 223 6th St, Brookings, SD 57006 | 2007-02-20 |
| Find all providers in zip 57006 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811008493 | Ronald Dustin Bodman | Optometrist | 586 5th St, Suite 300, Brookings, OR 97415-9720 | 2006-08-31 |
| 1699887158 | Wayne Robert Paulson | Optometrist | 586 5th St Ste 300, Brookings, OR 97415-9720 | 2006-08-31 |
| 1912010596 | Eye Center of Brookings, LLC | Optometrist | 937 Chetco Ave, Brookings, OR 97415 | 2006-08-16 |
| 1174556344 | Clayton Paul Twitero | Optometrist | 2425 6th St, Brookings, SD 57006-1733 | 2006-07-09 |
| 1982673927 | Kristin J Gurholt | Optometrist | 937k Chetco Ave 4005, Brookings, OR 97415 | 2006-03-14 |
| 1922095306 | Kristine Gyving | Optometrist | 325 5th St, Brookings, OR 97415-9658 | 2005-09-30 |
| 1609861608 | Jason Jahn | Optometrist | 1208 22nd Ave S, Brookings, SD 57006-2804 | 2005-09-15 |
| 1902806375 | Douglas John Walker | Optometrist | 937 Chetco Ave Ste K 4005, Brookings, OR 97415 | 2005-07-28 |
| 1447818562 | Taylor Allen Kneip | Optometrist | 2311 Yorkshire Dr, Brookings, SD 57006-2446 | 2019-06-04 |
| 1124371992 | Wyatt Nash-keller | Optometrist | 1208 22nd Ave S, Brookings, SD 57006-2804 | 2012-10-18 |
| Find all providers in BROOKINGS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.