Individual
DR. RUSSELL WAYNE ICKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
10352
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0212690001
MEDICARE DMERC REGION D
—
05
—
10090970A
—
KS
01
—
826580253
RAILROAD MEDICARE
—
Enumeration date
09/02/2005
Last updated
07/28/2010
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up