Kebert Eye Clinic PLLC

Primary specialty

OpticianTaxonomy code 156FX1800X

Legal business name

KEBERT EYE CLINIC PLLC

Doing business as

Kebert Optical Dispensary

Practice address

1307 Aston Avenue
McComb, MS 39648

Phone

(601) 684-8118

Fax

(601) 249-0846

NPI assigned

Dec 4, 2007

Last updated

Mar 18, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kent L Kebert, MDNPI 1285632943

Title

Ceo

Phone

(601) 684-8118

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kebert Optical Dispensary Doing business as

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kent L Kebert, MD

  • Ophthalmology Physician
  • McComb, MS
  • NPI 1285632943
  Medicare reassignment NPD Authorized official
• Daniel Marshall McClung Jr., MD

  • Ophthalmology Physician
  • McComb, MS
  • NPI 1952936908
  NPD
• Cole McKee Richardson, DO

  • Ophthalmology Physician
  • Hattiesburg, MS
  • NPI 1487148243
  NPD (past)
• Eugene Ainsworth Simmons Jr., M.D.

  • Ophthalmology Physician
  • Brookhaven, MS
  • NPI 1992766943
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1196726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300406400000",
    "number": "1003098898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 ASTON AVENUE",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "39648",
            "telephone_number": "601-684-8118",
            "fax_number": "601-249-0846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 ASTON AVENUE",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "39648",
            "telephone_number": "601-684-8118",
            "fax_number": "601-249-0846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEBERT EYE CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-04",
        "last_updated": "2011-03-18",
        "status": "A",
        "authorized_official_last_name": "KEBERT",
        "authorized_official_first_name": "KENT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "601-684-8118",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00880090",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kebert Optical Dispensary",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amanda Jordon
• Renie Jordon, M. D.
• Journey Transit and Travel, LLC
• Karen Bryant Luckett,DMD,PLLC
• Christos Kasapis, MD
• Kent L Kebert, MD
• Lynn Stone Kebert, O.D.
• Summer Keen
• Stephen Paul Keith, MD
• Erin Culpepper King, LPC

• Optician in McComb, MS
• Providers in McComb, MS by specialty
• Optician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.