Charles Henry Kinney, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

110978-9934 Issued in UT

Practice address

1950 Old Gallows Rd
Suite 520
Vienna, VA 22182-3990

Phone

(703) 847-8899

Fax

(703) 991-4051

NPI assigned

Dec 20, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in UT

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

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

State licenses

Practice roles (11 of 13)

Locations

Networks

• UT PPO
• UT PPO D-SNP

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.

• Standard Optical Co

  • Optometrist
  • Orem, UT
  • NPI 1093816548
  Medicare reassignment NPD
• Standard Optical Co

  • Optometrist
  • Ogden, UT
  • NPI 1538260021
  NPD
• Standard Optical Company

  • Optometrist
  • West Point, UT
  • NPI 1659958841
  NPD
• Myeyedr Optometry of North Carolina PLLC

  • Optometrist
  • Washington, NC
  • NPI 1043268295
  NPD (past)
• Standard Optical Co

  • Optometrist
  • Holladay, UT
  • NPI 1043311582
  NPD (past)
• Standard Optical Co

  • Optometrist
  • Roy, UT
  • NPI 1396832655
  NPD (past)
• Standard Optical Co

  • Optometrist
  • Tooele, UT
  • NPI 1477654846
  NPD (past)
• Standard Optical Co

  • Optometrist
  • Murray, UT
  • NPI 1508967977
  NPD (past)
• Standard Optical Co

  • Optometrist
  • Taylorsville, UT
  • NPI 1689775041
  NPD (past)
• Standard Optical Co

  • Optometrist
  • Layton, UT
  • NPI 1760583298
  NPD (past)
• Standard Optical Co

  • Optometrist
  • Salt Lake City, UT
  • NPI 1962599290
  NPD (past)

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

{
    "created_epoch": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517356800000",
    "number": "1124004338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14806 S ROSESCAPE CIR",
            "city": "HERRIMAN",
            "state": "UT",
            "postal_code": "840966978",
            "telephone_number": "336-613-8079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD",
            "address_2": "SUITE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823990",
            "telephone_number": "703-847-8899",
            "fax_number": "703-991-4051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINNEY",
        "first_name": "CHARLES",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-20",
        "last_updated": "2018-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "110978-9934",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1074",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7909490",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "09490",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Uriah Kim, PHARM.D.
• Janet Hutchison Kimberling, PH.D.
• Kinder Psychiatry PLLC
• Denys King, MS
• Kelly King, M.D.
• Hughston C Kirby, PT
• Katharina Kircanski, PHD
• Jeff Kircher, RPH
• Kiwi Therapy PLLC
• Brianna Kleinbrook

• All providers in Vienna, VA
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.