Gregory T Kipp, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC1387 Issued in FL

Practice address

3820 S Nova Rd
Port Orange, FL 32127-4949

Phone

(386) 767-0068

Fax

(386) 767-4755

NPI assigned

May 25, 2006

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

Enrolled in FL

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

Specialty

Optometry

Education

Southern California College of Optometry, 1977

Medicare assignment

May accept Medicare assignment

Group practices

Vision One IncGroup PAC ID 9830197623, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles (3 of 4)

Networks

• Freedom Health HMO Network

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.

• Vision One Inc

  • Optometrist
  • Daytona Beach, FL
  • NPI 1457308322

  FL

  Medicare reassignment Care Compare group
• Optical Shop of Palatka Inc

  • Eyewear Supplier
  • Palatka, FL
  • NPI 1669650255
  NPD (past)
• Vision One Inc

  • Optometrist
  • Port Orange, FL
  • NPI 1467538272
  NPD (past)
• Vision One Inc

  • Optometrist
  • Daytona Beach, FL
  • NPI 1952314346
  NPD (past)

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194393600000",
    "number": "1265488134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3820 S NOVA RD",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321274949",
            "telephone_number": "386-767-0068",
            "fax_number": "386-767-4755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3820 S NOVA RD",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321274949",
            "telephone_number": "386-767-0068",
            "fax_number": "386-767-4755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIPP",
        "first_name": "GREGORY",
        "middle_name": "T",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2007-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC1387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carson King, PT, DPT
• Edward Cecil King, LCSW
• Eric King
• Meagan King
• Shannon Marie King, LCSWC
• Pamela Kirby, D.P.M.
• Melanie Kirkman, M.S.
• Jessica Kirsch
• Kirsten Kim MD PA
• Ashley Kissam

• All providers in Port Orange, FL
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 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; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.