Individual provider Active NPI

Kevin Wayne Neal, O.D.

  • Optometrist
  • Cullman, AL
National Provider Identifier
1649263773
Registry record updated Jul 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
SA02-TA-581 Issued in AL
Practice address
626 Olive St SW
Cullman, AL 35055-5594
Phone
(256) 775-0269
Fax
(256) 775-6871
NPI assigned
Aug 24, 2005
Last updated
Jul 15, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X SA02-TA-581 AL Primary

Addresses

Primary practice location

626 Olive St SW
Cullman, AL 35055-5594

Mailing address

100 Sage Oak LN
Madison, AL 35758-4016
Phone (256) 520-7550

Other identifiers 1

IdentifierTypeStateIssuer
51504769OtherALBCBSAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20090708000387 AL Practitioner - Optometry 6507917390 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 2001
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

626 Olive St SW
Cullman, AL 35055-5594
Phone (256) 775-0269

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery30

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SA02-TA-581ALMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Kevin W. Neal, O.D., P.C. Optometrist CurrentSince Oct 30, 2001 Accepting new patients

Locations

626 Olive St SW
Cullman, AL 35055
Phone (256) 739-3390

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, 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": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594771200000",
    "number": "1649263773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SAGE OAK LN",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357584016",
            "telephone_number": "256-520-7550",
            "fax_number": "256-775-6871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 OLIVE ST SW",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350555594",
            "telephone_number": "256-775-0269",
            "fax_number": "256-775-6871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEAL",
        "first_name": "KEVIN",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "SA02-TA-581",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSAL",
            "identifier": "51504769",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cullman, AL

Sources for this page

Verify at the official NPI Registry.