Christopher Carmiencke, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1221 ATI Issued in OR

Practice address

452 NE Greenwood Ave
Bend, OR 97701-4645

Phone

(541) 382-5701

Fax

(541) 382-5702

NPI assigned

Jan 2, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Kit Carmiencke Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: christopher.carmiencke@direct.revolutionehr.com

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505952000000",
    "number": "1073670170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "452 NE GREENWOOD AVE",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977011134",
            "telephone_number": "541-382-5701",
            "fax_number": "541-382-5702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "452 NE GREENWOOD AVE",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014645",
            "telephone_number": "541-382-5701",
            "fax_number": "541-382-5702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARMIENCKE",
        "first_name": "CHRISTOPHER",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2017-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "OR",
            "license": "1221 ATI",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "1221 ATI",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03256-5",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIT",
            "last_name": "CARMIENCKE",
            "credential": "O.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Kayla Anne Carlson, PA-S
• Margaret Louise Carlson, B.S., L.M.T.
• Jessica Lindsey Carlton, LAC
• Melissa Foley Carlton, PT
• Megan Lynnleilani Carmichael, LAC
• Shara Carnahan
• Melissa W Carneiro
• Joyce A Carnes, MD
• Angela Christine Carney, RPH
• Jonathan Carney

• Optometrist in Bend, OR
• Providers in Bend, OR by specialty
• Optometrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2017; 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.