NPIMap

Organization Active NPI

Keddington & Kalra Optometrists Apc

Doing business as Otay Ranch Eyeworks Optometry

  • Optometrist
  • Chula Vista, CA
National Provider Identifier
1376793828
Registry record updated Mar 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6652 Issued in CA
Legal business name
KEDDINGTON & KALRA OPTOMETRISTS APC
Doing business as
Otay Ranch Eyeworks Optometry
Practice address
1741 Eastlake Pkwy Ste 101
Chula Vista, CA 91915-2032
Phone
(619) 421-6600
Fax
(619) 421-6006
NPI assigned
Sep 22, 2008
Last updated
Mar 10, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2009

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

Authorized official

Name
Dr. Joan Keddington, O.D.NPI 1992872691
Title
President
Phone
(619) 421-6600

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 6652 CA Primary

Addresses

Primary practice location

1741 Eastlake Pkwy Ste 101
Chula Vista, CA 91915-2032

Mailing address

1741 Eastlake Pkwy Ste 101
Chula Vista, CA 91915-2032
Phone (619) 421-6600

Other names 1

  • Otay Ranch Eyeworks Optometry Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060424000675 CA Part B Supplier - Clinic/Group Practice 0749290567 Receives reassigned benefits from 17 practitioners
2 other NPIs on this enrollment
Practice locations: Chula Vista, CA; National City, CA; Spring Valley, CA

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Eye Care Optometry Associates3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1741 Eastlake Pkwy
Ste 101
Chula Vista, CA 91915
Phone (619) 421-6600

687 Sweetwater Rd
Spring Valley, CA 91977
Phone (619) 466-9444

Practitioners & affiliated clinicians

Practitioners 19

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 19

NPI Registry JSON

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

{
    "created_epoch": "1222041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236643200000",
    "number": "1376793828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1741 EASTLAKE PKWY STE 101",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919152032",
            "telephone_number": "619-421-6600",
            "fax_number": "619-421-6006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1741 EASTLAKE PKWY STE 101",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919152032",
            "telephone_number": "619-421-6600",
            "fax_number": "619-421-6006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEDDINGTON & KALRA OPTOMETRISTS APC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-22",
        "last_updated": "2009-03-10",
        "status": "A",
        "authorized_official_last_name": "KEDDINGTON",
        "authorized_official_first_name": "JOAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-421-6600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "6652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Otay Ranch Eyeworks Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chula Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.