Kenneth Robert Epperson, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618000780 Issued in VA

Practice address

11369 Nuckols Rd
Glen Allen, VA 23059-5504

Phone

(804) 864-2020

Fax

(804) 377-8803

NPI assigned

Aug 8, 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

Medicare fee-for-service enrollment

Enrolled in VA

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

Southern California College of Optometry, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Myeyedr Optometry of Virginia, PLLCGroup PAC ID 0143448456, 133 clinicians

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.

• Myeyedr Optometry of Virginia PLLC

  • Optometrist
  • Ashburn, VA
  • NPI 1174933691
  Medicare reassignment Care Compare group NPD
• Myeyedr Optometry of Virginia, PLLC

  • Optometrist
  • Henrico, VA
  • NPI 1427704238
  NPD
• Myeyedr Optometry of Virginia, PLLC

  • Optometrist
  • North Chesterfield, VA
  • NPI 1932075983
  NPD

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1194735506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11369 NUCKOLS RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230595504",
            "telephone_number": "804-864-2020",
            "fax_number": "804-377-8803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EPPERSON",
        "first_name": "KENNETH",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618000780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Empowered Minds Behavioral Health
• Khairul B Emran, M.D.
• Envision Family Eyecare
• Gabriel Nonso Enwelum, PMHNP-C
• Epperson Eye,P.C.
• Sheree Epps, NP
• Ruth Erickson
• Nicholas Erizo
• Ryan Ernest, PMHNP-BC
• Ryley Spencer Camacho Escobar

• Optometrist in Glen Allen, VA
• Providers in Glen Allen, VA by specialty
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2022; 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.