Kipp Devine Beyerle, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

61360316 Issued in WA

Practice address

2255 Cape Pine Way
Colorado Springs, CO 80919-3882

Phone

(702) 533-3571

NPI assigned

Oct 5, 2022

Last updated

Oct 19, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1664928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666137600000",
    "number": "1366167033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2255 CAPE PINE WAY",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809193882",
            "telephone_number": "702-533-3571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2255 CAPE PINE WAY",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809193882",
            "telephone_number": "702-533-3571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEYERLE",
        "first_name": "KIPP",
        "middle_name": "DEVINE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-05",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "OPT.0003847",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "61360316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Optometrist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2022; 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.