Organization Active NPI

Kenton Family Eye Care, Inc.

  • Optometrist
  • Kenton, OH
National Provider Identifier
1306044516
Registry record updated Feb 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
KENTON FAMILY EYE CARE, INC.
Practice address
315 N Detroit St
Kenton, OH 43326-1575
Phone
(419) 673-5201
Fax
(419) 673-8652
NPI assigned
Jul 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2012

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

Authorized official

Name
Dr. Todd W Oates, O.D.NPI 1669447553
Title
President
Phone
(419) 673-5201

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

315 N Detroit St
Kenton, OH 43326-1575

Mailing address

315 N Detroit St
Kenton, OH 43326-1575
Phone (419) 673-5201

Other identifiers 1

IdentifierTypeStateIssuer
2251790MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031114000162 OH Part B Supplier - Clinic/Group Practice 9739093758 Receives reassigned benefits from 3 practitioners
Practice locations: Kenton, OH
O20100930000479 OH DME Supplier - Physician - Optometrist 9739093758 Practice locations: Kenton, OH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Kenton Family Eye Care Inc315 N Detroit St, Kenton, OH 43326-1575(419) 673-5201 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory

Locations

315 N Detroit St
Kenton, OH 43326
Phone (419) 673-5201

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329350400000",
    "number": "1306044516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 N DETROIT ST",
            "city": "KENTON",
            "state": "OH",
            "postal_code": "433261575",
            "telephone_number": "419-673-5201",
            "fax_number": "419-673-8652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 N DETROIT ST",
            "city": "KENTON",
            "state": "OH",
            "postal_code": "433261575",
            "telephone_number": "419-673-5201",
            "fax_number": "419-673-8652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENTON FAMILY EYE CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-10",
        "last_updated": "2012-02-16",
        "status": "A",
        "authorized_official_last_name": "OATES",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "419-673-5201",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2251790",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.