Individual provider Active NPI

Kristen Elizabeth Haskins Hillis, O.D.

  • Optometrist
  • Battle Creek, MI
National Provider Identifier
1457558041
Registry record updated Feb 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901005426 Issued in MI
Practice address
100 North Ave
Battle Creek, MI 49017-3417
Phone
(269) 962-7595
Fax
(269) 963-9202
NPI assigned
Jun 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD0000002690 TN
Pediatric Optometrist 152WP0200X OD0000002690 TN
Sports Vision Optometrist 152WS0006X OD0000002690 TN
Vision Therapy Optometrist 152WV0400X OD0000002690 TN
Optometrist 152W00000X 4901005426 MI Primary

Addresses

Primary practice location

100 North Ave
Battle Creek, MI 49017-3417

Mailing address

8614 Westwood Center Dr
Vienna, VA 22182-2442
Phone (703) 847-8899

Other names 1

  • Kristen Elizabeth Haskins Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20200831001502 MI Practitioner - Optometry 4880775907 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2006
Medicare assignment
May accept Medicare assignment
Group practices
Myeyedr Optometry of Michigan LLCGroup PAC ID 7416288949, 58 clinicians

Practice addresses (Care Compare)

65 Columbia Ave E
Battle Creek, MI 49015-3705
Phone (269) 965-5106

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OD0000002690TNMDSports Vision Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Michigan, LLC Optometrist CurrentSince Oct 18, 2021 Accepting new patients
Myeyedr Optometry of Michigan, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Michigan, LLC Optometrist CurrentSince Oct 18, 2021 Accepting new patients

Locations

7055 Tower Rd
Ste E
Battle Creek, MI 49014
Phone (269) 968-8183

100 North Ave
Ste E
Battle Creek, MI 49017
Phone (269) 962-7595

100 North Ave
Battle Creek, MI 49017
Phone (269) 288-8400

65 Columbia Ave E
Battle Creek, MI 49015
Phone (269) 342-0003

800 S Brown St
Jackson, MI 49203
Phone (517) 787-8890

5465 Gull Rd
Kalamazoo, MI 49048
Phone (269) 349-7631

2008 Washington Ave
Saint Joseph, MI 49085
Phone (269) 983-1303

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708646400000",
    "number": "1457558041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NORTH AVE",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490173417",
            "telephone_number": "269-962-7595",
            "fax_number": "269-963-9202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILLIS",
        "first_name": "KRISTEN",
        "middle_name": "ELIZABETH HASKINS",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-28",
        "last_updated": "2024-02-23",
        "certification_date": "2021-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "OD0000002690",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "TN",
            "license": "OD0000002690",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "TN",
            "license": "OD0000002690",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "TN",
            "license": "OD0000002690",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901005426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "HASKINS",
            "middle_name": "ELIZABETH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Battle Creek, MI

Sources for this page

Verify at the official NPI Registry.