Individual provider Active NPI

Lynn Stone Kebert, O.D.

  • Optometrist
  • McComb, MS
National Provider Identifier
1629476197
Registry record updated Dec 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
558 Issued in MS
Practice address
1307 Aston Ave
McComb, MS 39648-2898
Phone
(601) 684-8118
Fax
(601) 249-0846
NPI assigned
Dec 15, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 558 MS Primary

Addresses

Primary practice location

1307 Aston Ave
McComb, MS 39648-2898

Mailing address

1307 Aston Ave
McComb, MS 39648-2898
Phone (601) 684-8118

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
558MSMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Retina Specialists of Mississippi, PLLC PastSince Jan 15, 2015 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: lynnkebert@keberteye.direct.eyemdemr.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1418601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418601600000",
    "number": "1629476197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 ASTON AVE",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396482898",
            "telephone_number": "601-684-8118",
            "fax_number": "601-249-0846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 ASTON AVE",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396482898",
            "telephone_number": "601-684-8118",
            "fax_number": "601-249-0846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEBERT",
        "first_name": "LYNN",
        "middle_name": "STONE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-15",
        "last_updated": "2014-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McComb, MS

Sources for this page

Verify at the official NPI Registry.