Active NPI
Kenneth John Whitwell, O.D., MBA
- Optometrist
- Quantico, VA
National Provider Identifier
1386614352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4025T
- Practice address
- 3259 Catlin Ave
Quantico, VA 22134-5109 - Phone
- (703) 784-1526
- Fax
- (703) 784-1681
- NPI assigned
- Jan 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4025T | OR | Primary |
Addresses
Primary practice location
3259 Catlin Ave
Quantico, VA 22134-5109
Mailing address
3259 Catlin Ave
Quantico, VA 22134-5109
Phone (703) 784-1526
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Business Administration
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4025T | OR | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138060800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1386614352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3259 CATLIN AVE",
"city": "QUANTICO",
"state": "VA",
"postal_code": "221345109",
"telephone_number": "703-784-1526",
"fax_number": "703-784-1681"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3259 CATLIN AVE",
"city": "QUANTICO",
"state": "VA",
"postal_code": "221345109",
"telephone_number": "703-784-1526",
"fax_number": "703-784-1681"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITWELL",
"first_name": "KENNETH",
"middle_name": "JOHN",
"name_prefix": "Dr.",
"credential": "O.D., MBA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-24",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OR",
"license": "4025T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Quantico, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.