Joanna Kushon O.D. P.C.

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618001249 Issued in VA

Legal business name

JOANNA KUSHON O.D. P.C.

Practice address

3590 Holland Rd
Suite 104
Virginia Beach, VA 23452-4053

Phone

(757) 340-9680

Fax

(757) 463-5496

NPI assigned

Dec 13, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Joanna Carole Kushon, O.D.

Title

Owner

Phone

(757) 340-9680

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260316800000",
    "number": "1407917040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3590 HOLLAND RD",
            "address_2": "SUITE 104",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234524053",
            "telephone_number": "757-340-9680",
            "fax_number": "757-463-5496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3590 HOLLAND RD",
            "address_2": "SUITE 104",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234524053",
            "telephone_number": "757-340-9680",
            "fax_number": "757-463-5496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOANNA KUSHON O.D. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2009-12-09",
        "status": "A",
        "authorized_official_last_name": "KUSHON",
        "authorized_official_first_name": "JOANNA",
        "authorized_official_middle_name": "CAROLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "757-340-9680",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "C10476",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010129265",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 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.