Organization Active NPI

Cynthia Kiernan OD, Inc

  • Optometrist
  • Las Vegas, NV
National Provider Identifier
1659497923
Registry record updated Oct 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
CYNTHIA KIERNAN OD, INC
Practice address
2310 E Serene Ave
Las Vegas, NV 89123-3248
Phone
(702) 614-5435
Fax
(702) 614-5426
NPI assigned
Mar 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2017

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

Authorized official

Name
Dr. Cynthia Ann Kiernan, O.D.NPI 1396825014
Title
President
Phone
(702) 614-5435

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

2310 E Serene Ave
Las Vegas, NV 89123-3248

Mailing address

7732 Royal Oaks Rd
Las Vegas, NV 89123-2017
Phone (702) 614-5435

Other identifiers 1

IdentifierTypeStateIssuer
100507543MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100315000221 NV Part B Supplier - Clinic/Group Practice 8729113998 Receives reassigned benefits from 2 practitioners
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory

Locations

2310 E Serene Ave
Ste 1
Las Vegas, NV 89123
Phone (702) 614-5435

2310 E Serene Ave
#1
Las Vegas, NV 89123
Phone (702) 614-5435

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508976000000",
    "number": "1659497923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7732 ROYAL OAKS RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891232017",
            "telephone_number": "702-614-5435",
            "fax_number": "702-614-5426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 E SERENE AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891233248",
            "telephone_number": "702-614-5435",
            "fax_number": "702-614-5426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CYNTHIA KIERNAN OD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2017-10-26",
        "status": "A",
        "authorized_official_last_name": "KIERNAN",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-614-5435",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100507543",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.