Kerry Childers, O.D., P.a.

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

2038 Issued in AR

Legal business name

KERRY CHILDERS, O.D., P.A.

Practice address

618 Julia Ave E
Wynne, AR 72396-3504

Phone

(870) 238-9407

Fax

(870) 238-4320

NPI assigned

Feb 22, 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 Childers, OD

Title

Optometric Physician

Phone

(870) 238-9407

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

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

• Julia Rebecca Meyer Jackson, O.D.

  • Optometrist
  • Wynne, AR
  • NPI 1568627958

  Corneal and Contact Management

  NPD
• Ashley McGee, OD

  • Optometrist
  • Marion, AR
  • NPI 1932733185
  NPD

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238976000000",
    "number": "1568597409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 562",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "72396",
            "telephone_number": "870-238-9407",
            "fax_number": "870-238-4320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 JULIA AVE E",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "723963504",
            "telephone_number": "870-238-9407",
            "fax_number": "870-238-4320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KERRY CHILDERS, O.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2009-04-06",
        "status": "A",
        "authorized_official_last_name": "CHILDERS",
        "authorized_official_first_name": "KERRY",
        "authorized_official_title_or_position": "OPTOMETRIC PHYSICIAN",
        "authorized_official_telephone_number": "870-238-9407",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "AR",
            "license": "2038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110249722",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Truman Jones
• Lauren Nicole Kaiser
• Elaine M Kemp, PSY D
• Tori L Kemp, FNP-C
• Meredith Blaire Kennon
• Kids for the Future of Forrest City, Inc.
• Kids for the Future of Marion, Inc.
• Kids for the Future of Parkin, Inc.
• Kids for the Future Therapy Group, Inc.
• Kids for the Future, Inc.

• Corneal and Contact Management Optometrist in Wynne, AR
• Providers in Wynne, AR by specialty
• Corneal and Contact Management Optometrist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 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.

Verify at the official NPI Registry.