Individual provider Active NPI

Kyle Andrew Williams, OD

  • Optometrist
  • Chillicothe, OH
National Provider Identifier
1114538246
Registry record updated Aug 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT.006922 Issued in OH
Practice address
159 E 2ND St
Chillicothe, OH 45601-2526
Phone
(740) 773-6347
Fax
(740) 773-9093
NPI assigned
Aug 12, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT.006922 OH Primary

Addresses

Primary practice location

159 E 2ND St
Chillicothe, OH 45601-2526

Mailing address

159 E 2ND St
Chillicothe, OH 45601-2526
Phone (740) 773-6347

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20200909002920 OH Practitioner - Optometry 6406274349 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Buckeye Vision Care IncGroup PAC ID 5799780763, 4 clinicians

Practice addresses (Care Compare)

30652 Red Rock CT
Logan, OH 43138-9670
Phone (740) 385-4006

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT.006922OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Ohio Eye Surgical Associates LLC Optometrist CurrentSince Sep 1, 2020 Accepting new patients
Buckeye Vision Care Inc. Optometrist CurrentSince Dec 9, 2020 Accepting new patients
Southern Ohio Eye Surgery Center, LLC Current Accepting new patients
Southern Ohio Ophthalmic Anesthesia, LLC PastSince Sep 1, 2020 Accepting new patients

Locations

159 E 2nd St
Chillicothe, OH 45601
Phone (740) 773-6347

412 State Route 7 N
Gallipolis, OH 45631
Phone (740) 446-0112

30652 Red Rock Ct
Logan, OH 43138
Phone (740) 385-4006

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1597190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597190400000",
    "number": "1114538246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 E 2ND ST",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456012526",
            "telephone_number": "740-773-6347",
            "fax_number": "740-773-9093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 E 2ND ST",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456012526",
            "telephone_number": "740-773-6347",
            "fax_number": "740-773-9093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KYLE",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-12",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "OPT.006922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chillicothe, OH

Sources for this page

Verify at the official NPI Registry.