Active NPI
Kent Alan Korneisel, O.D.
- Optometrist
- Seattle, WA
National Provider Identifier
1508081381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 046-007678
- Practice address
- Dr Jennifer Andrews & Assoc
Third Ave. & Pine St
Seattle, WA 98181-0001 - Phone
- (206) 344-2020
- NPI assigned
- Apr 16, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | 046-007678 | IL | Primary |
Addresses
Primary practice location
Dr Jennifer Andrews & Assoc
Third Ave. & Pine St
Seattle, WA 98181-0001
Mailing address
9853 45TH Ave SW
Seattle, WA 98136-2710
Phone (206) 420-1015
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046-007678 | IL | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1235433600000",
"number": "1508081381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9853 45TH AVE SW",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981362710",
"telephone_number": "206-420-1015",
"fax_number": "206-420-1015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "DR JENNIFER ANDREWS & ASSOC",
"address_2": "THIRD AVE. & PINE ST",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981810001",
"telephone_number": "206-344-2020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KORNEISEL",
"first_name": "KENT",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-16",
"last_updated": "2009-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IL",
"license": "046-007678",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.