William Robert Kossol, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

0601001281 Issued in VA

Practice address

12100 Kennedy LN
#206
Fredericksburg, VA 22407-6760

Phone

(540) 785-3937

Fax

(540) 785-5498

NPI assigned

Sep 20, 2005

Reactivated

Apr 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 9

Medicare fee-for-service enrollment

Enrolled in VA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Sarah P. Brannon OD PC

  • Optometrist
  • Fredericksburg, VA
  • NPI 1669482600
  Medicare reassignment NPD

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261094400000",
    "number": "1649266248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12100 KENNEDY LN",
            "address_2": "#206",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224076760",
            "telephone_number": "540-785-3937",
            "fax_number": "540-785-5498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12100 KENNEDY LN",
            "address_2": "#206",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224076760",
            "telephone_number": "540-785-3937",
            "fax_number": "540-785-5498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSSOL",
        "first_name": "WILLIAM",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2009-12-18",
        "deactivation_date": "2006-03-23",
        "reactivation_date": "2006-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0601001281",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVESIS",
            "identifier": "17033",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS",
            "identifier": "6683",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLOCK",
            "identifier": "902137",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "C09338",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "452927",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09235591",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4091903",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "2150133",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "32467",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abbigail L Kopp, PHARMD
• Avery Kopp, BCABA
• Victoria Korankye
• Chelsea Sue Koskovich, AGACNP-BC
• Elizabeth Miranda Koss, MPT
• Jennifer R Kost-Phillips, DO
• Payal Kothari
• Jayarathne Kottage, MD
• Gina Marie Kotwicki, PT
• Stefan Kovacevic, MD

• Optometrist in Fredericksburg, VA
• Providers in Fredericksburg, VA by specialty
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.