Kimberly A Yeates, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

782 Issued in MS

Practice address

1913 Highway 45 N
Columbus, MS 39705-1950

Phone

(601) 917-0667

NPI assigned

Aug 1, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 9

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern College of Optometry, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Hattiesburg Eye Clinic, P.a.

  • Ophthalmology Physician
  • Hattiesburg, MS
  • NPI 1922110949

  MS, Optometrist

  Medicare reassignment NPD
• Perfectly Clear Eye Care, LLC

  • Optometrist
  • Columbus, MS
  • NPI 1154080844

  MS, Optometrist

  Medicare reassignment NPD
• Hattiesburg Eye Clinic, P.a.

  • Optometrist
  • Hattiesburg, MS
  • NPI 1700086162
  NPD
• Eye Clinic of Meridian PLLC

  • Ophthalmology Physician
  • Meridian, MS
  • NPI 1942285564

  Optometrist

  NPD (past)
• Butler Optical Center,Inc

  • Durable Medical Equipment & Medical Supplies
  • Butler, AL
  • NPI 1356409643
  NPD (past)
• Wal-Mart Stores East, LP

  • Pharmacy
  • Apollo Beach, FL
  • NPI 1437027208
  NPD (past)

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

{
    "created_epoch": "1185926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639094400000",
    "number": "1083804322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "834 HIGHWAY 12 W # 109",
            "city": "STARKVILLE",
            "state": "MS",
            "postal_code": "397593582",
            "telephone_number": "601-917-0667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1913 HIGHWAY 45 N",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397051950",
            "telephone_number": "601-917-0667"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5509 US-45 ALT S",
            "address_purpose": "LOCATION",
            "city": "West Point",
            "state": "MS",
            "postal_code": "39773",
            "country_code": "US",
            "telephone_number": "601-917-0667",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YEATES",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "name_prefix": "Miss",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-01",
        "last_updated": "2021-12-10",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS - BUTLER LOCATION",
            "identifier": "51593508",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104290",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00444208",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "$$$$$$$$$",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009912502",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS - LIVINGSTON LOCATION",
            "identifier": "51593510",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104442",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09172334",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF ALABAMA",
            "identifier": "73104815",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ruby F Wright
• Schqueira Wright, MS
• Traci L Wright, OTR/L
• Yeates Consulting ,LLC
• Edward Yeates
• Chelsee Monae Young
• Earleen Young
• Kayla Marie Young, OTD, OTR/L
• Annalisa Younger, PHARM D
• Martha Hope Younger, D.M.D.

• All providers in Columbus, MS
• Optometrist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.