Kodiak Vision Clinic & Sally's Eyeland, Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

AAO102 Issued in AK

Legal business name

KODIAK VISION CLINIC & SALLY'S EYELAND, INC.

Practice address

214 W Rezanof Dr
Kodiak, AK 99615-6044

Phone

(907) 486-6117

NPI assigned

Oct 17, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jerimiah Myers, O.D.

Title

Owner/Optometrist

Phone

(907) 486-6117

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1192579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491523200000",
    "number": "1285823062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 W REZANOF DR",
            "city": "KODIAK",
            "state": "AK",
            "postal_code": "996156044",
            "telephone_number": "907-486-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 W REZANOF DR",
            "city": "KODIAK",
            "state": "AK",
            "postal_code": "996156044",
            "telephone_number": "907-486-6117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KODIAK VISION CLINIC & SALLY'S EYELAND, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-17",
        "last_updated": "2017-04-07",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "JERIMIAH",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "907-486-6117",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AK",
            "license": "AAO102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kodiak Island Health Care Foundation (Kodiak Community Health Center)
• Kodiak Island Health Care Foundation (Kodiak Community Health Center Pharmacy)
• Kodiak Island Medical Associates LLC
• Kodiak Island Medical Associates LLC
• Kodiak Life Diagnostic Imaging, Inc
• John M Koller, M.D.
• Alicia Kostelecky
• Ashley Krimmel, RN, BSN
• Janna Lacroix
• Julia Lancaster

• Optometrist in Kodiak, AK
• Providers in Kodiak, AK by specialty
• Optometrist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2017; 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.