Richard A Kjome, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1477-035 Issued in WI

Practice address

714 3Rd Ave
Antigo, WI 54409-2044

Phone

(715) 623-2180

NPI assigned

Dec 28, 2006

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205992088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 238",
            "city": "ANTIGO",
            "state": "WI",
            "postal_code": "544090238",
            "telephone_number": "715-623-2180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 3RD AVE",
            "city": "ANTIGO",
            "state": "WI",
            "postal_code": "544092044",
            "telephone_number": "715-623-2180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KJOME",
        "first_name": "RICHARD",
        "middle_name": "A",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "1477-035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38563700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Joseph Kanke, D.D.S.
• Mary Jo Kautza, APRN
• Kristin King, RN
• Katherine Anne Kirwan, D.C.
• Tessa Kitzman
• Michelle A Klingler, OT
• Bartley R Kneeland, MD
• Jolene M Kopplin, NP
• Stephen M. Kordiyak, C.R.N.A.
• Michael Benjamin Kowitz

• Optometrist in Antigo, WI
• Providers in Antigo, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.