Kenneth S Kovach, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3295 Issued in OH

Practice address

4299 Kent Rd.
Suite #1
Stow, OH 44224-4365

Phone

(330) 688-1800

Fax

(330) 688-1824

NPI assigned

May 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289779200000",
    "number": "1376591784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4299 KENT RD.",
            "address_2": "SUITE #1",
            "city": "STOW",
            "state": "OH",
            "postal_code": "442244365",
            "telephone_number": "330-688-1800",
            "fax_number": "330-688-1824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4299 KENT RD.",
            "address_2": "SUITE #1",
            "city": "STOW",
            "state": "OH",
            "postal_code": "442244365",
            "telephone_number": "330-688-1800",
            "fax_number": "330-688-1824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVACH",
        "first_name": "KENNETH",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2010-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0441043",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sara Kline
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• John Christopher Komarc
• Audrey R. Kraynak, PH.D.
• Robert John Kubick Jr., PH.D., NCSP, SP527
• Joel Howard Kupfersmid, PH.D.
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• Michelle Lam, EMT

• Optometrist in Stow, OH
• Providers in Stow, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2010; 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.