Organization Active NPI

Keaton Optometry Inc.

Doing business as Dominion Eye Care Chesapeake

  • Optometrist
  • Chesapeake, VA
National Provider Identifier
1194541110
Registry record updated Nov 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
KEATON OPTOMETRY INC.
Doing business as
Dominion Eye Care Chesapeake
Practice address
1401 Kristina Way Unit 100
Chesapeake, VA 23320-8918
Phone
(757) 424-4177
NPI assigned
Nov 25, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2024

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

Authorized official

Name
Dr. Brook Lavinder Keaton, ODNPI 1740957570
Title
Optometrist/Business Owner
Phone
(540) 922-3847

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

1401 Kristina Way Unit 100
Chesapeake, VA 23320-8918

Mailing address

1401 Kristina Way Unit 100
Chesapeake, VA 23320-8918
Phone (757) 424-4177

Other identifiers 3

IdentifierTypeStateIssuer
1740957570OtherVABROOK KEATON OPTOMETRIC NPI
0618003125OtherVAOPTOMETRIC LICENSE
2664OtherNCOPTOMETRIC LICENSE

Other names 1

  • Dominion Eye Care Chesapeake Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250311000904 VA Part B Supplier - Clinic/Group Practice 1759802432 Receives reassigned benefits from 1 practitioner
Practice locations: Chesapeake, VA

National Provider Directory

National Provider Directory

Locations

1401 Kristina Way
Ste 100
Chesapeake, VA 23320
Phone (540) 922-3847

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1732492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732492800000",
    "number": "1194541110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 KRISTINA WAY UNIT 100",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233208918",
            "telephone_number": "757-424-4177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 KRISTINA WAY UNIT 100",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233208918",
            "telephone_number": "757-424-4177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEATON OPTOMETRY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-25",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-24",
        "status": "A",
        "authorized_official_last_name": "KEATON",
        "authorized_official_first_name": "BROOK",
        "authorized_official_middle_name": "LAVINDER",
        "authorized_official_title_or_position": "OPTOMETRIST/BUSINESS OWNER",
        "authorized_official_telephone_number": "540-922-3847",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BROOK KEATON OPTOMETRIC NPI",
            "identifier": "1740957570",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTOMETRIC LICENSE",
            "identifier": "0618003125",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTOMETRIC LICENSE",
            "identifier": "2664",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dominion Eye Care Chesapeake",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chesapeake, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.