NICHOLAS MICHAEL MCCULLEN (NPI# 1376854745) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376854745 |
| Entity Type | Individual |
| Full Name | NICHOLAS MICHAEL MCCULLEN |
| Credential | O.D. |
| Practice Address |
125 N 13th St Centerville IA 52544-1705 |
| Practice Telephone | 6414374099 |
| Practice Fax Number | 6414370512 |
| Mailing Telephone | 6414374099 |
| Mailing Fax Number | 6414370512 |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2013-10-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 002489 | IA | Eye and Vision Services Providers |
| Street Address |
125 N 13TH ST |
| City | CENTERVILLE |
| State | IA |
| Zip Code | 52544-1705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053363390 | Thomas Norman Johnson | Optometrist | 125 N 13th St, Centerville, IA 52544-1705 | 2006-05-16 |
| 1043668700 | Daniel Wallace Alletto | Optometrist | 125 N 13th St, Centerville, IA 52544-1705 | 2016-06-02 |
| 1043558299 | International Eyecare Center Inc | Eyewear Supplier (Equipment, not the service) | 125 N 13th St, Centerville, IA 52544-1705 | 2013-01-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053651166 | Amy Spencer | Pharmacist | 609 N. 18th Street, Centerville, IA 52544 | 2013-02-26 |
| 1710253497 | Caregivers Home Health, LLC | Home Health | 19999 Saint Josephs Drive, Centerville, IA 52544 | 2012-03-28 |
| 1558529206 | Mercy Medical Center-centerville | Clinic/Center | 19876 St. Joseph's Drive, Centerville, IA 52544 | 2008-05-29 |
| 1205023868 | Mercy Medical Center-centerville | Home Health | 1 St. Joseph's Drive, Centerville, IA 52544 | 2007-09-27 |
| 1043414394 | Appanoose Community Care Services | Home Health | 19890 St. Joseph's Drive, Centerville, IA 52544 | 2007-06-12 |
| 1659591816 | The Continental At St. Joseph's | Assisted Living Facility | 19999 St. Joseph's Drive, Centerville, IA 52544 | 2007-04-27 |
| 1255456315 | Kirk & Gordy Associates, LLC | Clinic/Center | 415 and A Half North Haynes, Centerville, IA 52544 | 2007-03-20 |
| 1114087574 | New Focus Inc | Clinic/Center | 102 W Washington, New Focus Inc, Centerville, IA 52544 | 2006-12-08 |
| 1134169030 | Ron Michael Harshman | Dentist | 501 W Jackson St, Centerville, IA 52544 | 2006-06-08 |
| 1700835865 | State University of Iowa | Family Medicine | 19876 St. Joseph Drive, Centerville, IA 52544 | 2006-05-08 |
| Find all providers in zip 52544 | ||||
| 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 |
|---|---|---|---|---|
| 1043405624 | Steven Michael Grout | Optometrist | 101 E Alex Bell Rd Ste 120, Centerville, OH 45459-2789 | 2007-09-07 |
| 1083739346 | Antonia K Taylor | Optometrist | 2930 Watson Blvd, Centerville, GA 31028-1245 | 2007-03-19 |
| 1053452110 | Tracy Tate | Optometrist | 5300 Cornerstone North Blvd, Centerville, OH 45440-2268 | 2007-02-10 |
| 1851466197 | Mason Matthew Wybrow | Optometrist | 308 N Market Place Dr, Centerville, UT 84014-1702 | 2006-11-22 |
| 1558468181 | Carol J Ballard | Optometrist | 205 1/2 E Public Sq, Centerville, TN 37033-1601 | 2006-09-17 |
| 1740215003 | Samuel A Borchers | Optometrist | 330 N Main Street, Suite #104, Centerville, OH 45459 | 2006-07-12 |
| 1881635381 | Lisa Timmerman | Optometrist | 125 E Franklin St, Centerville, OH 45459-5915 | 2006-06-08 |
| 1053363390 | Thomas Norman Johnson | Optometrist | 125 N 13th St, Centerville, IA 52544-1705 | 2006-05-16 |
| 1316921653 | Leland G Denhartog | Optometrist | 112 West Maple, Centerville, IA 52544 | 2005-11-30 |
| 1043668700 | Daniel Wallace Alletto | Optometrist | 125 N 13th St, Centerville, IA 52544-1705 | 2016-06-02 |
| Find all providers in CENTERVILLE | ||||
| City | CENTERVILLE |
| Zip Code | 52544 |
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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.