Individual provider Active NPI

Kristin Leigh Ham, OD

  • Optometrist
  • Platte City, MO
National Provider Identifier
1417915935
Registry record updated Aug 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2001016965 Issued in MO
Practice address
2600 Ensign Hill Dr
Suite F
Platte City, MO 64079-7836
Phone
(816) 431-2202
Fax
(816) 431-2205
NPI assigned
May 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046009634 IL
Optometrist 152W00000X 1594 KS
Optometrist 152W00000X 2001016965 MO Primary

Addresses

Primary practice location

2600 Ensign Hill Dr
Suite F
Platte City, MO 64079-7836

Mailing address

2716 N 25TH St
Ozark, MO 65721-9130
Phone (309) 369-7486

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20121005000268 MO Practitioner - Optometry 2264465442 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2001
Medicare assignment
May accept Medicare assignment
Group practices
KC Family Eyecare PCGroup PAC ID 0749272656, 3 clinicians

Practice addresses (Care Compare)

6000 N Oak Trfy
Suite 101
Gladstone, MO 64118-5176
Phone (816) 454-1030

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046009634ILMDOptometrist
1594KSMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
KC Family Eyecare PC Optometrist CurrentSince Aug 15, 2023 Accepting new patients

Locations

6000 N Oak Trfy
Ste 101
Kansas City, MO 64118
Phone (816) 454-1030

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346371200000",
    "number": "1417915935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2716 N 25TH ST",
            "city": "OZARK",
            "state": "MO",
            "postal_code": "657219130",
            "telephone_number": "309-369-7486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 ENSIGN HILL DR",
            "address_2": "SUITE F",
            "city": "PLATTE CITY",
            "state": "MO",
            "postal_code": "640797836",
            "telephone_number": "816-431-2202",
            "fax_number": "816-431-2205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAM",
        "first_name": "KRISTIN",
        "middle_name": "LEIGH",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-03",
        "last_updated": "2012-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009634",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1594",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2001016965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Platte City, MO

Sources for this page

Verify at the official NPI Registry.