Individual provider Active NPI

Christopher M. Kerby, O.D.

  • Optometrist
  • Marion, IN
National Provider Identifier
1124335138
Registry record updated Sep 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18003663B Issued in IN
Practice address
711 N River Dr
Marion, IN 46952-2672
Phone
(765) 664-9637
Fax
(765) 664-9792
NPI assigned
Sep 13, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18003663B IN Primary

Addresses

Primary practice location

711 N River Dr
Marion, IN 46952-2672

Mailing address

711 N River Dr
Marion, IN 46952-2672
Phone (765) 664-9637

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20101029000252 IN Practitioner - Optometry 9335333798 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aeg Indiana Professional PCGroup PAC ID 2365826179, 30 clinicians

Practice addresses (Care Compare)

2315 W Jefferson St
Preferred Eye Care Kokomo
Kokomo, IN 46901-4119
Phone (765) 455-0404

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18003663BINMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Aeg Indiana Professional PC Optometrist CurrentSince Sep 7, 2022 Accepting new patients
Dr Tabitha G Temple PC Optometrist PastSince Jul 16, 2007 Accepting new patients

Locations

2315 W Jefferson St
Kokomo, IN 46901
Phone (765) 342-3686

711 N River Dr
Marion, IN 46952
Phone (765) 388-3033

1500 Washington St
New Castle, IN 47362
Phone (317) 529-9364

2250 N Pointe Dr
Warsaw, IN 46582
Phone (574) 267-3515

Organizations & group practices 2

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": "1284336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284336000000",
    "number": "1124335138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 N RIVER DR",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469522672",
            "telephone_number": "765-664-9637",
            "fax_number": "765-664-9792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 N RIVER DR",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469522672",
            "telephone_number": "765-664-9637",
            "fax_number": "765-664-9792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERBY",
        "first_name": "CHRISTOPHER",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-13",
        "last_updated": "2010-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003663B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, IN

Sources for this page

Verify at the official NPI Registry.