Organization Active NPI

L. H. Kimball, LLC

  • Optometrist
  • Brattleboro, VT
National Provider Identifier
1104158997
Registry record updated Jun 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
030 0000113 Issued in VT
Legal business name
L. H. KIMBALL, LLC
Practice address
1222 Putney Rd
Brattleboro, VT 05301-9000
Phone
(802) 257-7453
Fax
(802) 254-6900
NPI assigned
Feb 4, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2010

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

Authorized official

Name
Lynde H. Kimball, O.D.
Title
Manager
Phone
(802) 257-7453

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 030 0000113 VT Primary

Addresses

Primary practice location

1222 Putney Rd
Brattleboro, VT 05301-9000

Mailing address

PO Box 8427
Brattleboro, VT 05304-8427
Phone (802) 257-7453

Other identifiers 3

IdentifierTypeStateIssuer
7910 VTMedicaidVT
KIMB 077 6175OtherBCBS
T25392OtherVTUPIN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1265241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276214400000",
    "number": "1104158997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8427",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "053048427",
            "telephone_number": "802-257-7453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 PUTNEY RD",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "053019000",
            "telephone_number": "802-257-7453",
            "fax_number": "802-254-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "L. H. KIMBALL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-04",
        "last_updated": "2010-06-11",
        "status": "A",
        "authorized_official_last_name": "KIMBALL",
        "authorized_official_first_name": "LYNDE",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "802-257-7453",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "VT",
            "license": "030 0000113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7910 VT",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "KIMB 077 6175",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "T25392",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brattleboro, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2010; 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.