Individual provider Active NPI

Neil William Kemp, O.D.

  • Optometrist
  • West Hartford, CT
National Provider Identifier
1417967324
Registry record updated Sep 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2390 Issued in CT
Practice address
1138 New Britain Ave
West Hartford, CT 06110-2413
Phone
(860) 236-0896
Fax
(860) 236-0898
NPI assigned
Aug 9, 2006
Last updated
Sep 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2390 CT Primary

Addresses

Primary practice location

1138 New Britain Ave
West Hartford, CT 06110-2413

Mailing address

1138 New Britain Ave
West Hartford, CT 06110-2413
Phone (860) 236-0896

Other identifiers 3

IdentifierTypeStateIssuer
002390OtherCONNECTICARE
0R4487OtherHEALTHNET
P2545366OtherOXFORD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20071018000685 CT Practitioner - Optometry 6204922461 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1138 New Britain Ave
West Hartford, CT 06110-2413
Phone (860) 236-0896

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002390CTMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
NWK Eyecare, LLC Optometrist CurrentSince Sep 24, 2007 Accepting new patients
New England Eyecare of Manchester, P.C. Optometrist Past Accepting new patients
New England Eyecare of Manchester, P.C. Optometrist Past Accepting new patients

Locations

1138 New Britain Ave
West Hartfrd, CT 06110
Phone (860) 236-0896

Organizations & group practices 3

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": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189209600000",
    "number": "1417967324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1138 NEW BRITAIN AVE",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061102413",
            "telephone_number": "860-236-0896",
            "fax_number": "860-236-0898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1138 NEW BRITAIN AVE",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061102413",
            "telephone_number": "860-236-0896",
            "fax_number": "860-236-0898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEMP",
        "first_name": "NEIL",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2007-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "2390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "002390",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "0R4487",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2545366",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hartford, CT

Sources for this page

Verify at the official NPI Registry.