Active NPI
Kevin D Obrien, M.D.
- Ophthalmology Physician
- Fall River, MA
National Provider Identifier
1477543536
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 36402
- Practice address
- 1565 N Main St
Ste 406
Fall River, MA 02720-2972 - Phone
- (508) 677-0041
- Fax
- (508) 677-0975
- NPI assigned
- Oct 28, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 36402 | MA | Primary |
Addresses
Primary practice location
1565 N Main St
Ste 406
Fall River, MA 02720-2972
Mailing address
1565 N Main St
Ste 406
Fall River, MA 02720-2972
Phone (508) 677-0041
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2015676 | Medicaid | MA |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36402 | MA | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1257292800000",
"number": "1477543536",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1565 N MAIN ST",
"address_2": "STE 406",
"city": "FALL RIVER",
"state": "MA",
"postal_code": "027202972",
"telephone_number": "508-677-0041",
"fax_number": "508-677-0975"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1565 N MAIN ST",
"address_2": "STE 406",
"city": "FALL RIVER",
"state": "MA",
"postal_code": "027202972",
"telephone_number": "508-677-0041",
"fax_number": "508-677-0975"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OBRIEN",
"first_name": "KEVIN",
"middle_name": "D",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-28",
"last_updated": "2009-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "MA",
"license": "36402",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2015676",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fall River, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.