Kevin Langeson Kish, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1673 Issued in MN

Practice address

352 S Main St
Box 38
Zumbrota, MN 55992-0038

Phone

(507) 732-7630

Fax

(507) 732-5401

NPI assigned

Nov 3, 2005

Last updated

Oct 16, 2008By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Zumbrota Optometric Center, P.a.

  • Optometrist
  • Zumbrota, MN
  • NPI 1891945374
  Authorized official Same address or phone

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224115200000",
    "number": "1225029697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "352 S MAIN ST",
            "address_2": "BOX 38",
            "city": "ZUMBROTA",
            "state": "MN",
            "postal_code": "559920038",
            "telephone_number": "507-732-7630",
            "fax_number": "507-732-5401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "352 S MAIN ST",
            "address_2": "BOX 38",
            "city": "ZUMBROTA",
            "state": "MN",
            "postal_code": "559920038",
            "telephone_number": "507-732-7630",
            "fax_number": "507-732-5401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISH",
        "first_name": "KEVIN",
        "middle_name": "LANGESON",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2008-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "1673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Zumbrota, MN
• Providers in Zumbrota, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2008; 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.