Individual provider Active NPI

Kenneth Cole, O.D.

  • Optometrist
  • Princeton, WV
National Provider Identifier
1245682608
Registry record updated Jul 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2022-IOD1 Issued in WV
Practice address
310 Locust St # 6
Princeton, WV 24740-3625
Phone
(304) 487-2020
NPI assigned
Jul 11, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2022-IOD1 WV Primary

Addresses

Primary practice location

310 Locust St # 6
Princeton, WV 24740-3625

Mailing address

310 Locust St # 6
Princeton, WV 24740-3625

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161207001457 WV Practitioner - Optometry 1254611361 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2016
Medicare assignment
May accept Medicare assignment
Group practices
Eyewear Express LTD IncGroup PAC ID 4183741903, 3 clinicians
A-Z IncGroup PAC ID 8628358728, 3 clinicians

Practice addresses (Care Compare)

229 Market Rd
Beckley, WV 25801-7114
Phone (304) 250-1050

310 Locust St
Suite 6
Princeton, WV 24740-3625
Phone (304) 487-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery20

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
A-Z, Inc. CurrentSince Jul 11, 2016 Accepting new patients
Eyewear Express LTD., Inc CurrentSince Jan 1, 2018 Accepting new patients
Eyewear Express Optometrist Past Accepting new patients

Locations

229 Market Rd
Beckley, WV 25801
Phone (304) 250-1050

310 Locust St
#6
Princeton, WV 24740
Phone (304) 487-2020

310 Locust St
Ste 6
Princeton, WV 24740
Phone (304) 487-2020

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468195200000",
    "number": "1245682608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 LOCUST ST # 6",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247403625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 LOCUST ST # 6",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247403625",
            "telephone_number": "304-487-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLE",
        "first_name": "KENNETH",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-11",
        "last_updated": "2016-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WV",
            "license": "2022-IOD1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, WV

Sources for this page

Verify at the official NPI Registry.