Individual provider Active NPI

Kurt Walter Finklang, O.D.

  • Optometrist
  • Troy, MO
National Provider Identifier
1447225867
Registry record updated Dec 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T02474 Issued in MO
Practice address
84 Professional Pkwy
Troy, MO 63379-2822
Phone
(636) 462-2110
Fax
(636) 528-7361
NPI assigned
Feb 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X T02474 MO Primary
Corneal and Contact Management Optometrist 152WC0802X T02474 MO

Addresses

Primary practice location

84 Professional Pkwy
Troy, MO 63379-2822

Mailing address

84 Professional Pkwy
Troy, MO 63379-2822
Phone (636) 462-2110

Other identifiers 1

IdentifierTypeStateIssuer
311616320MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
T02474MOMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1140393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261094400000",
    "number": "1447225867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84 PROFESSIONAL PKWY",
            "city": "TROY",
            "state": "MO",
            "postal_code": "633792822",
            "telephone_number": "636-462-2110",
            "fax_number": "636-528-7361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 PROFESSIONAL PKWY",
            "city": "TROY",
            "state": "MO",
            "postal_code": "633792822",
            "telephone_number": "636-462-2110",
            "fax_number": "636-528-7361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FINKLANG",
        "first_name": "KURT",
        "middle_name": "WALTER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-20",
        "last_updated": "2009-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T02474",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "MO",
            "license": "T02474",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "311616320",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 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.