Eyedentity, Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1750 Issued in WA

Legal business name

EYEDENTITY, INC.

Practice address

941 6TH St S
Kirkland, WA 98033-6712

Phone

(425) 822-7685

Fax

(425) 889-1664

NPI assigned

Jul 20, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Kerry Martin Atkins, O.D.NPI 1366553141

Title

Optometrist

Phone

(425) 822-7685

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kerry Martin Atkins, OD

  • Optometrist
  • Kirkland, WA
  • NPI 1366553141
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1184889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1477753226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "941 6TH ST S",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980336712",
            "telephone_number": "425-822-7685",
            "fax_number": "425-889-1664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "941 6TH ST S",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980336712",
            "telephone_number": "425-822-7685",
            "fax_number": "425-889-1664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYEDENTITY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-20",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "ATKINS",
        "authorized_official_first_name": "KERRY",
        "authorized_official_middle_name": "MARTIN",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "425-822-7685",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "1750",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2019784",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anna Marinda Evershed, N.D.
• Execmed, LLC
• Expert Bpo LLC.
• Eye and Contact Lens Center PS
• Eye Associates Northwest, PLLC
• Nathan Ezell
• Jayne Porsha Fabian Hamilton, RN, BSN
• Micayla Sarah Fadiga
• Stephanie-Joy Fagota
• Jasmyne Failds

• Optometrist in Kirkland, WA
• Providers in Kirkland, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.