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Deactivated NPI 1053412262 Deactivated / Inactive NPI Male Practitioner

Dr. Gary Nickel , OD, PA

Optometrist • Independence, KS

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Gary Nickel has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date September 26, 2006
NPI Deactivation Date July 23, 2019
Total Practice Duration ~13 Years of Practice (2006 – 2019)

Professional Overview & Biography Verified Profile Summary

Dr. Gary Nickel, OD, PA was a registered Optometrist practicing in Independence, KS. Throughout an active medical career spanning 13 years, Dr. Nickel provided care at the practice location at 404 N 14TH ST until profile deactivation on 2019-07-23.

Practice Location & Contact Primary Location

Practice Address

404 N 14th St

Independence, KS 673012909

Telephone 6203310910
Fax 6203312121
Associated Practice Facility / Clinic
🏢 Gary Nickel, Od, Pa Facility NPI 1538309620

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Independence, KS

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 24.5 Yrs
State Avg: 21.4 Yrs
Regional Practice Density
4 Specialists

Practicing in Independence, KS (751 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License KS 09562

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.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated July 23, 2019

Record deactivated on July 23, 2019

NPI Profile Active November 14, 2008

NPI status registered as active in NPPES database

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Updated Practice Location November 14, 2008

Registered at 404 N 14TH ST, INDEPENDENCE, KS 673012909 (Tel: 6203310910)

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Updated Business Mailing Address November 14, 2008

Registered at PO BOX 474, INDEPENDENCE, KS 673010474 (Tel: 6203310910)

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Provider Name / Credentials Updated November 14, 2008

Recorded as GARY NICKEL, O.D., P.A.

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Medical Taxonomy / Specialty Registered (Primary Specialty) November 14, 2008

Optometrist (License #09562 in KS)

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Initial NPI Registration & Enumeration September 26, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1053412262
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 26, 2006
Last Update: November 14, 2008
Deactivation Date: July 23, 2019

Mailing Address

Po Box 474

Independence, KS 673010474

Phone: 6203310910

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.