Kirk Howard OD PA

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

KIRK HOWARD OD PA

Practice address

2491 S Ferdon Blvd
Crestview, FL 32536

Phone

(850) 682-4014

Fax

(850) 682-0387

NPI assigned

Nov 17, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Charles Kirk Howard, OD

Title

Owner

Phone

(850) 682-4014

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Family Vision Center Doing business as

Locations

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206576000000",
    "number": "1114090875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2491 S FERDON BLVD",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "32536",
            "telephone_number": "850-682-4014",
            "fax_number": "850-682-0387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2491 S FERDON BLVD",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "32536",
            "telephone_number": "850-682-4014",
            "fax_number": "850-682-0387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIRK HOWARD OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2008-03-27",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "KIRK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-682-4014",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "21836",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Vision Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Michelle Koralewski, APRN, FNP-BC
• April Koski, RBT

• All providers in Crestview, FL
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2008; 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.