Keith a. Huelsman OD Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

4200 Issued in OH

Legal business name

KEITH A. HUELSMAN OD INC

Practice address

4301 State Route 725
Bellbrook, OH 45305-1552

Phone

(937) 848-3393

NPI assigned

Sep 6, 2007

Organization subpart

No

Name

Dr. Keith Allen Huelsman, OD

Title

Doctor

Phone

(937) 901-4902

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 25, 2008.

{
    "created_epoch": "1189036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206403200000",
    "number": "1497940027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 STATE ROUTE 725",
            "city": "BELLBROOK",
            "state": "OH",
            "postal_code": "453051552",
            "telephone_number": "937-848-3393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 STATE ROUTE 725",
            "city": "BELLBROOK",
            "state": "OH",
            "postal_code": "453051552",
            "telephone_number": "937-848-3393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEITH A. HUELSMAN OD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-06",
        "last_updated": "2008-03-25",
        "status": "A",
        "authorized_official_last_name": "HUELSMAN",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "937-901-4902",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "17615",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "114040",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "304246",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.