NPIMap

Individual provider Active NPI

David Ivor Kepner, O.D.

  • Optometrist
  • Wheaton, MD
National Provider Identifier
1043335359
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA1057 Issued in MD
Practice address
11193 Veirs Mill Rd
Wheaton, MD 20902-2534
Phone
(301) 946-4700
Fax
(301) 933-2238
NPI assigned
Mar 20, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA1057 MD Primary

Addresses

Primary practice location

11193 Veirs Mill Rd
Wheaton, MD 20902-2534

Mailing address

11193 Veirs Mill Rd
Wheaton, MD 20902-2534
Phone (301) 946-4700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
TA1057MDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Pearle Vision Wheaton Optometrist Past Accepting new patients
Ka Wheaton Inc Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043335359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11193 VEIRS MILL RD",
            "city": "WHEATON",
            "state": "MD",
            "postal_code": "209022534",
            "telephone_number": "301-946-4700",
            "fax_number": "301-933-2238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11193 VEIRS MILL RD",
            "city": "WHEATON",
            "state": "MD",
            "postal_code": "209022534",
            "telephone_number": "301-946-4700",
            "fax_number": "301-933-2238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEPNER",
        "first_name": "DAVID",
        "middle_name": "IVOR",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA1057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.