Kenneth Anthony Yeager

Primary specialty

OptometristTaxonomy code 152W00000X

License

1027 Issued in SC

Practice address

2304 W Parker Rd
Greenville, SC 29617-2123

Phone

(864) 246-0964

NPI assigned

May 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Blue Rose Eye Care PA

  • Optometrist
  • Greenville, SC
  • NPI 1306060199
  Medicare reassignment NPD

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602720000000",
    "number": "1568412344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2304W PARKER RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296172123",
            "telephone_number": "864-246-0964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2304 W PARKER RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296172123",
            "telephone_number": "864-246-0964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEAGER",
        "first_name": "KENNETH",
        "middle_name": "ANTHONY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1027",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D10272",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kyle Yates, DC
• Paul Yates IV, DDS
• Nimeshika Wasana Yatiyawela, PA
• Yazdy-Sokhandan PA
• Cynthia W Yeager, OD
• Alissa Green Yeargin, SLP
• Deborah Lynne Yeargin, FNP-BC
• Chelsea Yeatman
• Jane Adwoa Yeboah, CRNA
• Julie Yea Teen Yeh, M.D.

• Optometrist in Greenville, SC
• Providers in Greenville, SC by specialty
• Optometrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.