Active NPI
David John Kriley, OD
- Optometrist
- Tamaqua, PA
National Provider Identifier
1629162482
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OE005128T
- Practice address
- 35 Plaza Dr
Rte 309 North
Tamaqua, PA 18252-4405 - Phone
- (570) 668-2672
- Fax
- (570) 668-2683
- NPI assigned
- Oct 3, 2006
- Last updated
- Dec 20, 2011
- 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 | OE005128T | PA | Primary |
Addresses
Primary practice location
35 Plaza Dr
Rte 309 North
Tamaqua, PA 18252-4405
Mailing address
35 Plaza Drive
Route 309 North
Tamaqua, PA 18252-4450
Phone (570) 668-2672
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 553634 | Other | PA | NATIONAL VISION A |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OE005128T | PA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Luxottica of America Inc | Past | Accepting new patients | |
| Wal-Mart Stores East, L.P. | Past | Accepting new patients | |
| Luxottica of America Inc | Past | Accepting new patients |
Organizations & group practices 3
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": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1324339200000",
"number": "1629162482",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35 PLAZA DRIVE",
"address_2": "ROUTE 309 NORTH",
"city": "TAMAQUA",
"state": "PA",
"postal_code": "182524450",
"telephone_number": "570-668-2672",
"fax_number": "570-668-2683"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35 PLAZA DR",
"address_2": "RTE 309 NORTH",
"city": "TAMAQUA",
"state": "PA",
"postal_code": "182524405",
"telephone_number": "570-668-2672",
"fax_number": "570-668-2683"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRILEY",
"first_name": "DAVID",
"middle_name": "JOHN",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-03",
"last_updated": "2011-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "PA",
"license": "OE005128T",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATIONAL VISION A",
"identifier": "553634",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tamaqua, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.