Individual provider Active NPI

Kimberly Ann Yee, OD

  • Optometrist
  • Lacon, IL
National Provider Identifier
1124533047
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046.009423 Issued in IL
Practice address
114 5TH St
Lacon, IL 61540-1206
Phone
(309) 246-8177
NPI assigned
Dec 14, 2017
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046.009423 IL Primary

Addresses

Primary practice location

114 5TH St
Lacon, IL 61540-1206

Mailing address

610 Patricia LN
Henry, IL 61537-1069
Phone (309) 364-3049

Other practice location 1

420 N 4th St
Chillicothe, IL 61523-2002
Phone (309) 274-5411

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20180119001844 IL Practitioner - Optometry 0345509329 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2001
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

610 Patricia LN
Henry, IL 61537-1069

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046.009423ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
John J Geiser O.D. Optometrist PastSince Jan 8, 2018 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1513209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1124533047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 PATRICIA LN",
            "city": "HENRY",
            "state": "IL",
            "postal_code": "615371069",
            "telephone_number": "309-364-3049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 5TH ST",
            "city": "LACON",
            "state": "IL",
            "postal_code": "615401206",
            "telephone_number": "309-246-8177"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "420 N 4th St",
            "address_purpose": "LOCATION",
            "city": "Chillicothe",
            "state": "IL",
            "postal_code": "615232002",
            "country_code": "US",
            "telephone_number": "309-274-5411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YEE",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-14",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.009423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lacon, IL

Sources for this page

Verify at the official NPI Registry.