Individual provider Active NPI

John R. Kerr, O.D.

  • Optometrist
  • Sewickley, PA
National Provider Identifier
1417958968
Registry record updated Dec 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG-000888 Issued in PA
Practice address
411 Beaver St
Sewickley, PA 15143-1501
Phone
(412) 741-8920
Fax
(412) 741-6852
NPI assigned
Aug 9, 2005
Last updated
Dec 1, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 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 OEG-000888 PA Primary

Addresses

Primary practice location

411 Beaver St
Sewickley, PA 15143-1501

Mailing address

411 Beaver St
Sewickley, PA 15143-1501
Phone (412) 741-8920

Other identifiers 1

IdentifierTypeStateIssuer
001785566MedicaidPA

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
I20050915000945 PA Practitioner - Optometry 0446283832 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG-000888PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Visionworks, Inc. Optometrist CurrentSince May 23, 2024 Accepting new patients
Aeg Pennsylvania Professional, Inc Optometrist CurrentSince Jul 6, 2019 Accepting new patients
Aeg Pennsylvania Professional, Inc Optometrist CurrentSince Jul 6, 2019 Accepting new patients
Visionworks, Inc CurrentSince May 23, 2024 Accepting new patients
Aeg Pennsylvania Professional Inc Optometrist CurrentSince Dec 1, 2023 Accepting new patients

Locations

211 E Broadway
Alton, IL 62002
Phone (314) 787-0681

560 Millcreek Mall
Erie, PA 16565
Phone (814) 868-8540

2300 E Lincoln Hwy
Langhorne, PA 19047
Phone (215) 750-3760

187 Scharberry Ln
Mars, PA 16046
Phone (724) 591-5501

411 Beaver St
Sewickley, PA 15143
Phone (412) 422-5300

4835 Lyndon B Johnson Fwy
Ste 850
Dallas, TX 75244

Organizations & group practices 5

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": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480550400000",
    "number": "1417958968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 BEAVER ST",
            "city": "SEWICKLEY",
            "state": "PA",
            "postal_code": "151431501",
            "telephone_number": "412-741-8920",
            "fax_number": "412-741-6852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 BEAVER ST",
            "city": "SEWICKLEY",
            "state": "PA",
            "postal_code": "151431501",
            "telephone_number": "412-741-8920",
            "fax_number": "412-741-6852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERR",
        "first_name": "JOHN",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2016-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG-000888",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001785566",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sewickley, PA

Sources for this page

Verify at the official NPI Registry.