Active NPI
Paul Alan Klenklen, O.D.
- Corneal and Contact Management Optometrist
- Overland Park, KS
National Provider Identifier
1205911260
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Corneal and Contact Management Optometrist
- License
- 1455-3
- Practice address
- 7701 Frontage Rd Ste a
Overland Park, KS 66204-2364 - Phone
- (913) 648-3072
- Fax
- (913) 648-6597
- NPI assigned
- Oct 26, 2006
- Last updated
- Jun 12, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Corneal and Contact Management Optometrist | 152WC0802X | 1455 | KS | |
| Corneal and Contact Management Optometrist | 152WC0802X | T03213 | MO | |
| Corneal and Contact Management Optometrist | 152WC0802X | 1455-3 | KS | Primary |
Addresses
Primary practice location
7701 Frontage Rd Ste a
Overland Park, KS 66204-2364
Mailing address
7701 Frontage Rd Ste a
Overland Park, KS 66204-2364
Phone (913) 648-3072
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1455-3 | KS | MD | Corneal and Contact Management Optometrist |
| T03213 | MO | MD | Corneal and Contact Management Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| National Vision Inc | Past | Accepting new patients |
Organizations & group practices 1
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": "1161820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1402531200000",
"number": "1205911260",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7701 FRONTAGE RD STE A",
"city": "OVERLAND PARK",
"state": "KS",
"postal_code": "662042364",
"telephone_number": "913-648-3072",
"fax_number": "913-648-6597"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7701 FRONTAGE RD STE A",
"city": "OVERLAND PARK",
"state": "KS",
"postal_code": "662042364",
"telephone_number": "913-648-3072",
"fax_number": "913-648-6597"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLENKLEN",
"first_name": "PAUL",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-26",
"last_updated": "2014-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "KS",
"license": "1455",
"primary": false
},
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "MO",
"license": "T03213",
"primary": false
},
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "KS",
"license": "1455-3",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Overland Park, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.