Active NPI
Jiro Kameoka, O.D.
- Optometrist
- Fountain, CO
National Provider Identifier
1699730440
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPT-2215
- Practice address
- 6310 S US Highway 85-87
Fountain, CO 80817-1006 - Phone
- (719) 390-8649
- NPI assigned
- Apr 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPT-2215 | CO | Primary |
| Corneal and Contact Management Optometrist | 152WC0802X | OPT-2215 | CO |
Addresses
Primary practice location
6310 S US Highway 85-87
Fountain, CO 80817-1006
Mailing address
727 Bear Paw LN S
Colorado Springs, CO 80906-3220
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 24476323 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPT-2215 | CO | MD | Corneal and Contact Management Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145232000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203897600000",
"number": "1699730440",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "727 BEAR PAW LN S",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809063220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6310 S US HIGHWAY 85-87",
"city": "FOUNTAIN",
"state": "CO",
"postal_code": "808171006",
"telephone_number": "719-390-8649"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAMEOKA",
"first_name": "JIRO",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-17",
"last_updated": "2008-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CO",
"license": "OPT-2215",
"primary": true
},
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "CO",
"license": "OPT-2215",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "24476323",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fountain, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.