Kirk N De Young, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1640 Issued in SC

Practice address

2701 David H McLeod Blvd
Florence, SC 29501-4043

Phone

(843) 664-2000

NPI assigned

Sep 22, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1285113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459987200000",
    "number": "1649588708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "967 CARDINAL CIR",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295053013",
            "telephone_number": "920-316-0616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 DAVID H MCLEOD BLVD",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295014043",
            "telephone_number": "843-664-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE YOUNG",
        "first_name": "KIRK",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-09-22",
        "last_updated": "2016-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3192-35",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sophia B Davis
• Tabatha O'Tasha Davis, MA
• Yashica Davis
• Dawson and Dawson Family Dentistry
• Alfred Gilchrist Dawson, MD
• Marilyn Dean
• Dorothy Deas
• Kevin A Deas
• Richetta Deas, ANP-C
• Sisay Getahun Debebe, M.D.

• Optometrist in Florence, SC
• Providers in Florence, SC by specialty
• Optometrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2016; 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.