NPIMap

Organization Active NPI

H Kenneth Kopolow O.D & Assoc P.C

Doing business as Dr. Kenneth Kopolow O.D.

  • Optometrist
  • Las Vegas, NV
National Provider Identifier
1336186444
Registry record updated Sep 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
274 Issued in NV
Legal business name
H KENNETH KOPOLOW O.D & ASSOC P.C
Doing business as
Dr. Kenneth Kopolow O.D.
Practice address
4300 Meadows LN
Ste 126
Las Vegas, NV 89107-3004
Phone
(702) 733-6764
Fax
(702) 614-6018
NPI assigned
May 31, 2006
Last updated
Sep 16, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
KOPOLOW & GIRISGEN OD, PC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 16, 2009

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

Authorized official

Name
Harlan Kenneth Kopolow, O.DNPI 1013962604
Title
President
Phone
(702) 733-6764

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
Optometrist 152W00000X 274 NV Primary

Addresses

Primary practice location

4300 Meadows LN
Ste 126
Las Vegas, NV 89107-3004

Mailing address

7361 W Lake Mead Blvd
Ste 104
Las Vegas, NV 89128-1040
Phone (702) 733-6764

Other identifiers 1

IdentifierTypeStateIssuer
100507862MedicaidNV

Other names 1

  • Dr. Kenneth Kopolow O.D. Doing business as

National Provider Directory

National Provider Directory
Part of
Koplow Girisgen Proff

Locations

4300 Meadows Ln
Ste 126
Las Vegas, NV 89107
Phone (702) 258-0073

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253059200000",
    "number": "1336186444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7361 W LAKE MEAD BLVD",
            "address_2": "STE 104",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891281040",
            "telephone_number": "702-733-6764",
            "fax_number": "702-255-5797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 MEADOWS LN",
            "address_2": "STE 126",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891073004",
            "telephone_number": "702-733-6764",
            "fax_number": "702-614-6018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "H KENNETH KOPOLOW O.D & ASSOC P.C",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KOPOLOW & GIRISGEN  OD, PC.",
        "enumeration_date": "2006-05-31",
        "last_updated": "2009-09-16",
        "status": "A",
        "authorized_official_last_name": "KOPOLOW",
        "authorized_official_first_name": "HARLAN",
        "authorized_official_middle_name": "KENNETH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-733-6764",
        "authorized_official_credential": "O.D"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "274",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100507862",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Kenneth Kopolow O.D.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2009; 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.