Active NPI
L. H. Kimball, LLC
- Optometrist
- Brattleboro, VT
National Provider Identifier
1104158997
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 030 0000113
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7910 VT | Medicaid | VT | |
| KIMB 077 6175 | Other | BCBS | |
| T25392 | Other | VT | UPIN |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Optometrist
- Brattleboro, VT
- NPI 1306841507
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.