Individual provider Active NPI

Evan R Kuhn, O.D.

  • Optometrist
  • Baxter, MN
National Provider Identifier
1568611622
Registry record updated May 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3127 Issued in MN
Practice address
7295 Glory Rd
Baxter, MN 56425-7308
Phone
(218) 829-3848
NPI assigned
Sep 15, 2008
Last updated
May 11, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046010093 IL
Optometrist 152W00000X 3127 MN Primary

Addresses

Primary practice location

7295 Glory Rd
Baxter, MN 56425-7308

Mailing address

7295 Glory Rd
Baxter, MN 56425-7308
Phone (218) 829-3848

Other practice location 1

255 Lincoln Mall Dr
Matteson, IL 60443-2328
Phone (708) 481-8722

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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

Enrollment IDStateProvider typePAC IDDetails
I20150203000448 MN Practitioner - Optometry 1153499488

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3127MNMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Luxottica of America Inc Past Accepting new patients
Midwest Family Eye Center Optometrist PastSince Feb 2, 2015 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1221436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620691200000",
    "number": "1568611622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7295 GLORY RD",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564257308",
            "telephone_number": "218-829-3848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7295 GLORY RD",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564257308",
            "telephone_number": "218-829-3848"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "255 Lincoln Mall Dr",
            "address_purpose": "LOCATION",
            "city": "Matteson",
            "state": "IL",
            "postal_code": "604432328",
            "country_code": "US",
            "telephone_number": "708-481-8722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUHN",
        "first_name": "EVAN",
        "middle_name": "R",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-15",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010093",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baxter, MN

Sources for this page

Verify at the official NPI Registry.