RYAN PETERSON OD, INC. (NPI# 1730654385) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730654385 |
| Entity Type | Organization |
| Organization Name | RYAN PETERSON OD, INC. |
| Practice Address |
5691 Rickenbacker Rd Nellis Afb NV 89191-7052 |
| Mailing Address |
936 Baronet Dr Las Vegas NV 89138-8016 |
| Practice Telephone | 7026446671 |
| Mailing Telephone | 7026834481 |
| Enumeration Date | 2018-10-10 |
| Last Update Date | 2018-10-10 |
| Authorized Official Name | DR. RYAN KENT PETERSON (PRESIDENT/OPTOMETRIST) |
| Authorized Official Telephone | 7022996200 |
| Authorized Official Credential | OD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | Eye and Vision Services Providers |
| Street Address |
5691 RICKENBACKER RD |
| City | NELLIS AFB |
| State | NV |
| Zip Code | 89191-7052 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255327011 | Conrad Lochner IIi | Optometrist | 5691 Rickenbacker Rd, Bx Mall, Bldg 431, Nellis Afb, NV 89191-7052 | 2005-09-26 |
| 1255379913 | National Vision, Inc. | Eyewear Supplier (Equipment, not the service) | 5691 Rickenbacker Rd, Building 431, Nellis Afb, NV 89191-7052 | 2006-06-03 |
| 1184607095 | Vorapas Thunyalukul | Optometrist | 5691 Rickenbacker Rd, Bx Mall Bldg 431, Nellis Afb, NV 89191-7052 | 2005-11-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225662687 | Ashley Raye Roth-garcia | Student in an Organized Health Care Education/Training Program | 99th Medical Group 4700 Las Vegas Blvd North, Nellis Afb, NV 89191 | 2020-02-25 |
| 1427553734 | Christopher Robert Weisgarber | Student in an Organized Health Care Education/Training Program | Mike O'callaghan Military Medical Center, 4700 Las Vegas Blvd North Bldg 1300, Las Vegas, NV 89191 | 2018-03-28 |
| 1912345448 | Austin Joseph Ladner | Dentist | 99th Air Base Wing Public Affairs, Fpo, AA 89191 | 2013-06-06 |
| 1528329018 | Mayer M Jeppson | Psychologist | 4700 Las Vegas Blvd. N, Nellis Afb, NV 89191 | 2012-05-31 |
| 1255560462 | Jordan Lawrence | Military Health Care Provider | 1579 Malmstrom Avenue, Nellis Afb, NV 89191 | 2009-07-09 |
| 1225263072 | Adrienne L Clark | Military Health Care Provider | 5154 Ellsworth Ave, Suite 61690, Las Vegas, NV 89191 | 2009-05-22 |
| 1568634335 | Eleanor C Basilio | Registered Nurse | 4700 Las Vegas Blvd., Nellis Afb, NV 89191 | 2008-04-01 |
| 1316137037 | Sarah Rachel Glick | Pediatrics | 4700 N. Las Vegas Blvd., Mike O'callaghan Federal Medical Center, 99 Mdos/sgoc, Nellis Afb, NV 89191 | 2007-07-30 |
| 1619181302 | Ben Carter Robinson | Orthopaedic Surgery | 4700 N. Las Vegas Blvd, Nellis Afb-mofh Nellis Orthopedics, Las Vegas, NV 89191 | 2007-05-10 |
| 1609992205 | Conrad Lochner IIi, Odpc | Optometrist | 5691 Rickenbacker Road, Bldg. 431, Las Vegas, NV 89191 | 2007-03-22 |
| Find all providers in zip 89191 | ||||
| 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 |
|---|---|---|---|---|
| 1285626259 | Laurie Rene Davie | Optometrist | 4311 Carswell Ave Bldg 340, Nellis Afb, NV 89191-7069 | 2005-08-16 |
| 1609281880 | Lance D Higbee | Optometrist | 4700 Las Vegas Blvd North, 99 Amds/sgpe, Nellis Afb, NV 89191-6601 | 2014-06-25 |
| 1578849170 | William Catt | Optometrist | 4700 N. Las Vegas Blvd, Nellis Afb, NV 89191 | 2011-10-26 |
| 1548548068 | Linda N Anacleto | Optometrist | 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 | 2011-08-02 |
| 1265682645 | Ivy Tat Madson | Optometrist | 4700 Las Vegas Blvd N Bldg 1300, Nellis Afb, NV 89191-6600 | 2008-09-23 |
| 1548427800 | Jenny H. Kim | Optometrist | 4700 Las Vegas Blvd N, Attention: Credentialing, Nellis Afb, NV 89191-6600 | 2008-05-22 |
| 1932160744 | Christopher B Stanley | Optometrist | 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 | 2006-03-31 |
| 1184607095 | Vorapas Thunyalukul | Optometrist | 5691 Rickenbacker Rd, Bx Mall Bldg 431, Nellis Afb, NV 89191-7052 | 2005-11-23 |
| 1396732632 | Adam B Klemens | Optometrist | 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 | 2005-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366040305 | Dr Martinez Od, Pllc | Optometrist | 3515 Saint Rose Pkwy Ste 110, Henderson, NV 89052-4596 | 2020-10-13 |
| 1558972331 | Shirlene Jade Luu | Optometrist | 4343 N Rancho Dr Ste 116, Las Vegas, NV 89130-3421 | 2020-08-13 |
| 1831709104 | Jenny Wong | Optometrist | 9260 W Sunset Rd Ste 209, Las Vegas, NV 89148-4903 | 2020-08-03 |
| 1245853407 | Dana Vo Od, Ltd | Optometrist | 3900 Spring Mountain Rd Ste 1, Las Vegas, NV 89102-8650 | 2020-05-22 |
| 1841838331 | Vision Consultants | Optometrist | 660 S Martin Luther King Blvd, Las Vegas, NV 89106-4413 | 2019-12-15 |
| 1073156824 | Beena Mangalbhai Patel | Optometrist | 9484 W Flamingo Rd Ste 280, Las Vegas, NV 89147-5746 | 2019-10-24 |
| 1386294106 | Amy Nguyen Optometric Professional Corporation | Optometrist | 4080 N Martin Luther King Blvd, North Las Vegas, NV 89032 | 2019-09-13 |
| 1033766431 | Optic Gallery South Meadows LLC | Optometrist | 770 S Meadows Pkwy Ste 108&109, Reno, NV 89521-3862 | 2019-08-20 |
| 1437706934 | Sirintr/suk Pllc | Optometrist | 6085 S Fort Apache Rd Ste 120-130, Las Vegas, NV 89148-5545 | 2019-08-20 |
| 1346802568 | Rickie Kwong Chin Jr. | Optometrist | 695 S. Green Valley Pkwy, Henderson, NV 89052 | 2019-07-08 |
| Find all providers with the same taxonomy | ||||
| City | NELLIS AFB |
| Zip Code | 89191 |
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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.