Provider Demographics
NPI:1871605097
Name:NYE, THOMAS EDWARD (OD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:EDWARD
Last Name:NYE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:644 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45011-6005
Mailing Address - Country:US
Mailing Address - Phone:513-887-1100
Mailing Address - Fax:513-887-2671
Practice Address - Street 1:644 HIGH ST
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-6005
Practice Address - Country:US
Practice Address - Phone:513-887-1100
Practice Address - Fax:513-887-2671
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3955152WC0802X, 152WL0500X, 152WP0200X, 152WS0006X, 152WV0400X, 152WX0102X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WS0006XEye and Vision Services ProvidersOptometristSports Vision
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
No152WX0102XEye and Vision Services ProvidersOptometristOccupational Vision
Provider Identifiers
StateIdentifier IDID TypeIssuer
10995OtherNVA
299210001OtherADMINISTAR
OH31121465200OtherBWC PROVIDER #
311214652OtherUNITED HEALTHCARE
000000014180OtherANTHEM
311214652OtherTRICARE
311214652OtherHUMANA/CHOICE CARE
OH311214652026OtherCARE SOURCE
OH0669316Medicaid
311214652OtherAETNA
10995OtherNVA
OH0669316Medicaid
OH0299210001Medicare NSC