Individual provider Active NPI

Kennard Herring, O.D.

  • Optometrist
  • Philadelphia, PA
National Provider Identifier
1417360769
Registry record updated Nov 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG002906 Issued in PA
Practice address
6656 Germantown Ave
Suite 1
Philadelphia, PA 19119-2163
Phone
(718) 825-2067
NPI assigned
Jun 4, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG002906 PA Primary

Addresses

Primary practice location

6656 Germantown Ave
Suite 1
Philadelphia, PA 19119-2163

Mailing address

6656 Germantown Ave
Suite 1
Philadelphia, PA 19119-2163
Phone (718) 825-2067

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140804000228 PA Practitioner - Optometry 4789801473 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6656 Germantown Ave
Philadelphia, PA 19119-2105
Phone (215) 842-5939

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nostalgic Eyecare Inc CurrentSince Dec 1, 2016 Accepting new patients
Renal Care Group East, Inc. Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1401840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480291200000",
    "number": "1417360769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6656 GERMANTOWN AVE",
            "address_2": "SUITE 1",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191192163",
            "telephone_number": "718-825-2067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6656 GERMANTOWN AVE",
            "address_2": "SUITE 1",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191192163",
            "telephone_number": "718-825-2067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRING",
        "first_name": "KENNARD",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-04",
        "last_updated": "2016-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG002906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.