Kim P Cory, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

18001658A Issued in IN

Practice address

6509 Central Ave
Portage, IN 46368-3101

Phone

(219) 762-4801

Fax

(219) 764-9974

NPI assigned

Feb 23, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Optometry

Education

Other, 1974

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Cory Eyecare PTR

  • Eyewear Supplier
  • Portage, IN
  • NPI 1033379987

  Optometrist

  NPD Authorized official

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213142400000",
    "number": "1164498945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6509 CENTRAL AVE",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463683101",
            "telephone_number": "219-762-4801",
            "fax_number": "219-764-9974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6509 CENTRAL AVE",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463683101",
            "telephone_number": "219-762-4801",
            "fax_number": "219-764-9974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORY",
        "first_name": "KIM",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2008-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18001658A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100207890",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christina Connelly, FNP-C
• Terria Conwell
• Kylee Cook
• Theresa Annette Cooley, PT
• Cory Eyecare PTR
• Scott A Cory, MD
• Taliea Crouch
• David John Cryderman, D.C.
• Jacob Cunningham
• Hasan Daik, DMD

• Optometrist in Portage, IN
• Providers in Portage, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2008; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.