Kornmesser Optometry Clinic Inc PS.

Primary specialty

OptometristTaxonomy code 152W00000X

License

09-0000870 Issued in WA

Legal business name

KORNMESSER OPTOMETRY CLINIC INC PS.

Practice address

422 W Birch St
Shelton, WA 98584-1735

Phone

(360) 426-5578

Fax

(360) 462-5580

NPI assigned

Aug 31, 2009

Organization subpart

No

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

Authorized official

Name

Ms. Merrieann Godding

Title

Manager

Phone

(360) 426-5578

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. James H. Grimes Other name

Tax ID family

Dr James H Grimes2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Kornmesser Optometry Clinic Inc PS

  • Optometrist
  • Olympia, WA
  • NPI 1205961836
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joseph John Theodore Renaud, OD

  • Optometrist
  • Shelton, WA
  • NPI 1952926636
  NPD (past)

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

{
    "created_epoch": "1251676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300406400000",
    "number": "1649403122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "422 W BIRCH ST",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985841735",
            "telephone_number": "360-426-5578",
            "fax_number": "360-462-5580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 W BIRCH ST",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985841735",
            "telephone_number": "360-426-5578",
            "fax_number": "360-462-5580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KORNMESSER OPTOMETRY CLINIC INC PS.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-31",
        "last_updated": "2011-03-18",
        "status": "A",
        "authorized_official_last_name": "GODDING",
        "authorized_official_first_name": "MERRIEANN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "360-426-5578",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "09-0000870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2467009",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. James H. Grimes",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Elizabeth Klaniecki, RDH
• Melinda Carol Kleppen, LMP
• Meteja Klukas
• Misty Knight, LMP
• Bernadine Lee Knutz, CDPT
• Kori Markus Kronmeyer, CO61098828
• Amanda M Krupp, LMP
• Joy L. Kulhanek, SLP
• Jennifer Lynn Kummerfeldt, ARNP
• Mathew Kummerfeldt, PA-C

• Optometrist in Shelton, WA
• Providers in Shelton, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.

Verify at the official NPI Registry.