NPIMap

Organization Active NPI

Kehoe Eye Care PC

  • Optometrist
  • Galesburg, IL
National Provider Identifier
1235104035
Registry record updated Dec 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
KEHOE EYE CARE PC
Practice address
4-L Plaza
Suite 35
Galesburg, IL 61401
Phone
(309) 343-1179
Fax
(309) 343-5287
NPI assigned
Feb 23, 2006
Last updated
Dec 7, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2007

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

Authorized official

Name
Peter H Kohoe, OD
Title
President
Phone
(309) 343-1179

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X Primary

Addresses

Primary practice location

4-L Plaza
Suite 35
Galesburg, IL 61401

Mailing address

4-L Plaza
Suite 35
Galesburg, IL 61401
Phone (309) 343-1179

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060103000358 IL Part B Supplier - Clinic/Group Practice 4789606880 Receives reassigned benefits from 7 practitioners
1 other NPI on this enrollment
Practice locations: Galesburg, IL; Galva, IL; Monmouth, IL

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

261 N Broad St
Ste 35
Galesburg, IL 61401
Phone (309) 343-1179

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196985600000",
    "number": "1235104035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4-L PLAZA",
            "address_2": "SUITE 35",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "61401",
            "telephone_number": "309-343-1179",
            "fax_number": "309-343-5287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4-L PLAZA",
            "address_2": "SUITE 35",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "61401",
            "telephone_number": "309-343-1179",
            "fax_number": "309-343-5287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEHOE EYE CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-23",
        "last_updated": "2007-12-07",
        "status": "A",
        "authorized_official_last_name": "KOHOE",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-343-1179",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galesburg, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2007; 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.