Brett D Koons, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2007031193 Issued in MO

Practice address

323 E Highway 54
Suite 104
Camdenton, MO 65020-9599

Phone

(573) 346-7899

Fax

(573) 346-7744

NPI assigned

Oct 25, 2007

Last updated

Oct 25, 2007By the provider in NPPES

Sex

Male

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 1

Medicare fee-for-service enrollment

Enrolled in MO

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

University of Missouri St Louis - School of Optometry, 2007

Medicare assignment

May accept Medicare assignment

Group practices

Lens Mart IncGroup PAC ID 0345217170, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: brett.koons@direct.revolutionehr.com

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

• Lens Mart Inc

  • Eyewear Supplier
  • Camdenton, MO
  • NPI 1275566044

  Optometrist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1193270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193270400000",
    "number": "1083893192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1314",
            "city": "CAMDENTON",
            "state": "MO",
            "postal_code": "650201314",
            "telephone_number": "573-346-7899",
            "fax_number": "573-346-7744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 E HIGHWAY 54",
            "address_2": "SUITE 104",
            "city": "CAMDENTON",
            "state": "MO",
            "postal_code": "650209599",
            "telephone_number": "573-346-7899",
            "fax_number": "573-346-7744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOONS",
        "first_name": "BRETT",
        "middle_name": "D",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-25",
        "last_updated": "2007-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2007031193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "2007031193",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carolyn Kenney, RN
• James A. Kinnard
• Kirby J. Robinson, DDS of Missouri, LLC (Affordable Dentures & Implants - Camdenton)
• Taren Kirk
• Michael Kirkover, M.D.
• Anton Kosov, M.D.
• Terry S Krantz, RN FNP
• Lake Area Citizens' Advisory Board, Inc. (Lake Area Counseling & Behavioral Health)
• Lake Area Industries, Inc.
• Lake Dental Clinic LLC

• Optometrist in Camdenton, MO
• Providers in Camdenton, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2007; 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.