Kenneth Boyer OD, Inc

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

KENNETH BOYER OD, INC

Practice address

2443 Foothill Blvd
La Verne, CA 91750-3028

Phone

(909) 596-6756

Fax

(909) 593-0786

NPI assigned

Mar 16, 2020

Organization subpart

Yes

Parent organization

KENNETH BOYER OD, INC.As reported in NPPES

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

Authorized official

Name

Ms. Patricia Ann Daniels

Title

Insurance Coordinator/Biller

Phone

(909) 596-6756

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Part of

Kenneth Boyer OD Inc

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kenneth James Boyer, O.D.

  • Optometrist
  • La Verne, CA
  • NPI 1801961453
  NPD
• James Joseph Cutler, O.D.

  • Optometrist
  • Upland, CA
  • NPI 1982702023
  NPD (past)

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

{
    "created_epoch": "1584316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1164058798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2443 FOOTHILL BLVD",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917503028",
            "telephone_number": "909-596-6756",
            "fax_number": "909-593-0786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2443 FOOTHILL BLVD",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917503028",
            "telephone_number": "909-596-6756",
            "fax_number": "909-593-0786"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1637 N Mountain Ave",
            "address_purpose": "LOCATION",
            "city": "Upland",
            "state": "CA",
            "postal_code": "917841732",
            "country_code": "US",
            "telephone_number": "909-982-0100",
            "fax_number": "909-985-1552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KENNETH BOYER OD, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KENNETH BOYER OD, INC.",
        "enumeration_date": "2020-03-16",
        "last_updated": "2023-11-27",
        "certification_date": "2020-03-26",
        "status": "A",
        "authorized_official_last_name": "DANIELS",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "INSURANCE COORDINATOR/BILLER",
        "authorized_official_telephone_number": "909-596-6756",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GSD000651",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "EHR",
            "affiliation": "Y",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "EHR",
            "address_1": "2443 Foothill Blvd",
            "city": "LA Verne",
            "state": "CA",
            "country_code": "US",
            "postal_code": "917503028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Optometrist in La Verne, CA
• Providers in La Verne, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.