Kenneth David Grier, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC 1474 Issued in FL

Practice address

10250 SE 167TH Place Rd Unit 5
Summerfield, FL 34491

Phone

(352) 307-9925

Fax

(352) 307-8442

NPI assigned

Aug 16, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

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.

• Jimmy Nguyen OD PA

  • Optometrist
  • Kissimmee, FL
  • NPI 1821394891
  NPD (past)

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527811200000",
    "number": "1710979794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10250 SE 167TH PLACE RD UNIT 5",
            "city": "SUMMERFIELD",
            "state": "FL",
            "postal_code": "344918682",
            "telephone_number": "352-307-9225",
            "fax_number": "352-307-8442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10250 SE 167TH PLACE RD UNIT 5",
            "city": "SUMMERFIELD",
            "state": "FL",
            "postal_code": "34491",
            "telephone_number": "352-307-9925",
            "fax_number": "352-307-8442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIER",
        "first_name": "KENNETH",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2018-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 1474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012979400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Summerfield, FL
• Providers in Summerfield, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2018; 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.