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DR. RUSSELL WAYNE ICKE OD NPI 1134113319


NPI Information

NPI: 1134113319
Provider Name: DR. RUSSELL WAYNE ICKE, OD
Classification: Optometrist - 152W00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
7050 E LINCOLN ST
WICHITA, KS
ZIP 67207
Phone: (316) 683-9671
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DR. Russell Wayne Icke, OD is an optometrist in Wichita, KS with 52 years of experience. The provider is 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. DR. Russell Wayne Icke, OD NPI is 1134113319. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: PENNSYLVANIA COLLEGE OF OPTOMETRY
Graduation Year:1972

The provider's business location address is:

7050 E LINCOLN ST
WICHITA, KS
ZIP 67207-638
Phone: (316) 683-9671
Fax: (316) 683-0168

The NPI 1134113319 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Eye and medical examination for diagnosis and treatment, established patient (HCPCS:92012)
  • Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits (HCPCS:92014)

The enumeration date for this NPI number is 9/2/2005 and was last updated on 7/28/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1152W00000XOptometrist10352KANSASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10212690001OTHERMEDICARE DMERC REGION D
2826580253OTHERRAILROAD MEDICARE
3T77478MEDICARE UPIN
4005294MEDICARE ID-TYPE UNSPECIFIEDKANSAS
510090970AMEDICAIDKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.