DR. RUSSELL L DOERKSEN (NPI# 1528166634) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528166634 |
| Entity Type | Individual |
| Full Name | DR. RUSSELL L DOERKSEN |
| Credential | O.D. |
| Practice Address |
7570 W 21st St N Bldg 1002 Wichita KS 67205-1734 |
| Practice Telephone | 3167213377 |
| Practice Fax Number | 3167216077 |
| Mailing Telephone | 3167213377 |
| Mailing Fax Number | 3167216077 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2015-06-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 1324 | KS | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | PREFERRED HEALTH SYSTEM | 3712 | 01 |
| KS | BLUE CROSS/BLUE SHIELD | 049837 | 01 |
| Street Address |
7570 W 21ST ST N BLDG 1002 |
| City | WICHITA |
| State | KS |
| Zip Code | 67205-1734 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093711244 | Peeples Orthotics & Prosthetics LLC | Prosthetic/Orthotic Supplier | 7570 W 21st St N, Ste 1026b, Wichita, KS 67205-1734 | 2005-06-22 |
| 1811547102 | Janel Hartwell | Marriage & Family Therapist | 7570 W 21st St N, Wichita, KS 67205-1734 | 2019-09-18 |
| 1639526536 | Axiom Counseling & Therapy Services | Marriage & Family Therapist | 7570 W 21st St N, Building1042 Suite B, Wichita, KS 67205-1734 | 2016-05-20 |
| 1568835742 | Stefanie Marie Roth | Registered Nurse | 7570 W 21st St N, Suite 1026 D, Wichita, KS 67205-1734 | 2015-11-10 |
| 1336530716 | Bethany Owens | Social Worker | 7570 W 21st St N, Suite 1026d, Wichita, KS 67205-1764 | 2015-02-06 |
| 1356603575 | Steven J Dold | Dentist | 7570 W 21st St N, Ste 1026b, Wichita, KS 67205-1734 | 2012-06-13 |
| 1861752859 | Brent Carpenter | Dentist | 7570 W 21st St N, Building 1010, Wichita, KS 67205-1734 | 2012-05-23 |
| 1487880282 | Joshua Warren Davis | Dentist | 7570 W 21st St N, Bldg. 1050 Suite B, Wichita, KS 67205-1734 | 2009-06-08 |
| 1972740843 | Reflection Ridge Dental, LLC | Point of Service | 7570 W 21st St N, 1050b, Wichita, KS 67205-1734 | 2009-01-14 |
| 1619136702 | Craig Douglas Ratzlaff | Dentist | 7570 W 21st St N, Bldg 1020 Ste A, Wichita, KS 67205-1734 | 2008-06-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295211910 | Emily M Chastain | Dentist | 3213 N. Ridge Rd, Wichita, KS 67205 | 2018-07-16 |
| 1811415466 | Awaken Psychology LLC | Clinic/Center | 2552 N Maize Ct Suite 600, Wichita, KS 67205 | 2017-09-05 |
| 1962940288 | Moc Wichita LLC | Assisted Living Facility | 7057 W Village Circle, Wichita, KS 67205 | 2017-02-07 |
| 1003362732 | Moc Wichita, LLC | Assisted Living Facility | 7057 West Village Circle, Wichita, KS 67205 | 2016-09-01 |
| 1649637653 | Abigail Friend | Audiologist-Hearing Aid Fitter | 2558 Lake Way Circle, Wichita, KS 67205 | 2016-01-21 |
| 1134505399 | Myles Davidson | Dentist | 3510 N Ridge Rd Ste 500, Wichita, KS 67205 | 2015-08-10 |
| 1093121097 | The Eye Gallery, LLC | Optometrist | 3084 N. Maize Rd, Wichita, KS 67205 | 2014-07-10 |
| 1922428721 | Sam's West, Inc. | Technician/Technologist | 3084 N. Maize Road, Witchita, KS 67205 | 2014-04-18 |
| 1447693627 | Caryn Rana Landreth | Social Worker | 3114 N Brush Creek St, Wichita, KS 67205 | 2013-04-08 |
| 1902182686 | Return To Motion Medical | Durable Medical Equipment & Medical Supplies | 3221 N Ridge Port Circle, Wichita, KS 67205 | 2011-10-26 |
| Find all providers in zip 67205 | ||||
| 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 |
|---|---|---|---|---|
| 1114544392 | Diana Ho | Optometrist | 980 Oliver Street, Wichita, KS 67218 | 2020-07-03 |
| 1861040909 | Larisa Rivera | Optometrist | 949 S Glendale St, Wichita, KS 67218-3210 | 2019-09-02 |
| 1427612084 | Kansas Physicians Eyecare Group, P.C. | Optometrist | 438 S Rock Rd, Wichita, KS 67207-1150 | 2019-04-29 |
| 1396213799 | Wichita Optometry, P.a. | Optometrist | 2330 N Amidon Ave, Wichita, KS 67204-5630 | 2018-11-05 |
| 1710463500 | Macey Pruett | Optometrist | 982 N Tyler Rd Ste A, Wichita, KS 67212-3271 | 2018-07-14 |
| 1295116333 | Jedediah Reece | Optometrist | 7570 W 21st St N Ste 1002, Wichita, KS 67205-1763 | 2015-06-15 |
| 1093121097 | The Eye Gallery, LLC | Optometrist | 3084 N. Maize Rd, Wichita, KS 67205 | 2014-07-10 |
| 1427498047 | Vanlang Q Huynh | Optometrist | 7700 E Kellogg Dr Ste 703a, Wichita, KS 67207-1787 | 2013-06-27 |
| 1063790145 | Megan Nichole Baldwin | Optometrist | 2146 N Collective Ln, 110, Wichita, KS 67206-3573 | 2011-07-24 |
| 1649578402 | Lentz Enterprises, LLC | Optometrist | 670 E 47th St S, Wichita, KS 67216-1769 | 2011-03-03 |
| Find all providers in WICHITA | ||||
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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.