Dr. Kenneth M Boxer & Associates PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT001183 Issued in GA

Legal business name

DR. KENNETH M BOXER & ASSOCIATES PC

Practice address

2370 N Druid Hills Rd NE
Atlanta, GA 30329-3105

Phone

(404) 321-2020

Fax

(404) 321-2025

NPI assigned

Dec 6, 2013

Organization subpart

No

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

Authorized official

Name

Kenneth M Boxer, ODNPI 1609990506

Title

Optometrist/Owner

Phone

(404) 321-2020

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

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.

• Kenneth Martin Boxer, OD

  • Optometrist
  • Atlanta, GA
  • NPI 1609990506
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1386288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386288000000",
    "number": "1285065938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2370 N DRUID HILLS RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303293105",
            "telephone_number": "404-321-2020",
            "fax_number": "404-321-2025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2370 N DRUID HILLS RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303293105",
            "telephone_number": "404-321-2020",
            "fax_number": "404-321-2025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. KENNETH M BOXER & ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-06",
        "last_updated": "2013-12-06",
        "status": "A",
        "authorized_official_last_name": "BOXER",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "404-321-2020",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT001183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2013; 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.