Wesley Don Kemp, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

T02963 Issued in MO

Practice address

325 S Main Ave
Bolivar, MO 65613-2052

Phone

(417) 777-9000

Fax

(417) 777-9003

NPI assigned

Aug 24, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Ozarks Resource Group

  • Federally Qualified Health Center (FQHC)
  • Hermitage, MO
  • NPI 1639421050
  Medicare reassignment NPD
• Ozarks Resource Group

  • Federally Qualified Health Center (FQHC)
  • Urbana, MO
  • NPI 1659942027
  NPD

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203379200000",
    "number": "1457344525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 42",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656130042",
            "telephone_number": "417-777-9000",
            "fax_number": "417-777-9003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 S MAIN AVE",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656132052",
            "telephone_number": "417-777-9000",
            "fax_number": "417-777-9003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEMP",
        "first_name": "WESLEY",
        "middle_name": "DON",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2008-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T02963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "313115305",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristopher J Kaufmann, DO
• Ryan Andrew Kedzie, DO
• Phillip Kelchen, M.D.
• Kemp Family Eye Care, LLC
• Lou Thelen Kemp, MA
• Kayla Kittle, MD
• Ajdin Kobic, MD
• Zackery Koch, BA, MAADAC-I
• Kathleen Noell Kroutil, OTR/L
• Ashley Michele Lane, D.O.

• Optometrist in Bolivar, MO
• Providers in Bolivar, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.