Kathleen D Keltz, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1646 Issued in IA

Practice address

605 Ninth St
Hawarden, IA 51023-2220

Phone

(712) 551-1603

Fax

(712) 551-1490

NPI assigned

Apr 5, 2006

Last updated

Nov 21, 2007By the provider in NPPES

Sex

Female

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kathleen D Keltz

  • Eyewear Supplier
  • Hawarden, IA
  • NPI 1407038508
  NPD (past) Authorized official

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195603200000",
    "number": "1720040736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 153",
            "city": "HAWARDEN",
            "state": "IA",
            "postal_code": "510230153",
            "telephone_number": "712-551-1603",
            "fax_number": "712-551-1490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 NINTH ST",
            "city": "HAWARDEN",
            "state": "IA",
            "postal_code": "510232220",
            "telephone_number": "712-551-1603",
            "fax_number": "712-551-1490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELTZ",
        "first_name": "KATHLEEN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-05",
        "last_updated": "2007-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "1646",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9201220",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0147090",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hawarden Regional Healthcare
• Hawarden Regional Healthcare Clinics LLC (Hawarden Clinic)
• Hawarden Regional Healthcare Clinics LLC
• Matt Hummel
• Kathleen D Keltz
• Karen Sue Kennedy, ARNP
• Lynn Kious, DPT
• Bo-Hsin Kong, DDS
• Carrie Korleski
• Mary Jo Lee, OTR/L

• Optometrist in Hawarden, IA
• Providers in Hawarden, IA by specialty
• Optometrist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2007; 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.