Active NPI
Daniel James Kierstead, OD
- Optometrist
- Fond Du Lac, WI
National Provider Identifier
1487731741
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2009
- Practice address
- 377 N Rollings Meadows Dr
Fond Du Lac, WI 54937 - Phone
- (920) 921-8022
- Fax
- (920) 921-8254
- NPI assigned
- Nov 1, 2006
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2009 | WI | Primary |
Addresses
Primary practice location
377 N Rollings Meadows Dr
Fond Du Lac, WI 54937
Mailing address
3160 Old Orchard LN
Oshkosh, WI 54902
Phone (920) 232-1236
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1487731741",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3160 OLD ORCHARD LN",
"city": "OSHKOSH",
"state": "WI",
"postal_code": "54902",
"telephone_number": "920-232-1236"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "377 N ROLLINGS MEADOWS DR",
"city": "FOND DU LAC",
"state": "WI",
"postal_code": "54937",
"telephone_number": "920-921-8022",
"fax_number": "920-921-8254"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIERSTEAD",
"first_name": "DANIEL",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WI",
"license": "2009",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fond Du Lac, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.