Kenton Scott McDougall, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD00001246 Issued in WA

Practice address

298 S Main St
Suite 301
Colville, WA 99114-2447

Phone

(509) 684-2221

Fax

(509) 684-6222

NPI assigned

Aug 30, 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 2

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196726400000",
    "number": "1245340116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "298 S MAIN ST",
            "address_2": "SUITE 301",
            "city": "COLVILLE",
            "state": "WA",
            "postal_code": "991142447",
            "telephone_number": "509-684-2221",
            "fax_number": "509-684-6222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "298 S MAIN ST",
            "address_2": "SUITE 301",
            "city": "COLVILLE",
            "state": "WA",
            "postal_code": "991142447",
            "telephone_number": "509-684-2221",
            "fax_number": "509-684-6222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDOUGALL",
        "first_name": "KENTON",
        "middle_name": "SCOTT",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00001246",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "0022969",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2030500",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chelsea Ann Matz, LMFT
• Manfred E Mayer, RN
• Sophia J McCammant
• Jenny Marie McCombs
• Peter C McCombs
• Kurtis R McDowell
• Ashley McHan
• Elizabeth Allene McKellar
• April M McKenna, DPM
• Kate McKern

• Optometrist in Colville, WA
• Providers in Colville, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.