Individual provider Active NPI

Erin Kindy, O.D.

  • Optometrist
  • Rogers, AR
National Provider Identifier
1720420037
Registry record updated Feb 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2697 Issued in AR
Practice address
1401 W Walnut St
Rogers, AR 72756-3317
Phone
(479) 636-2012
Fax
(479) 631-7416
NPI assigned
Jul 28, 2013
Last updated
Feb 26, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3126 TN
Optometrist 152W00000X 2697 AR Primary

Addresses

Primary practice location

1401 W Walnut St
Rogers, AR 72756-3317

Mailing address

1180 Natchez PT Apt 27
Memphis, TN 38103-0953
Phone (479) 903-2411

Other practice location 1

650 New York St
Memphis, TN 38104-5536
Phone (901) 728-5858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160330000170 AR Practitioner - Optometry 5294978334 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1401 W Walnut St
Rogers, AR 72756-3317

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
2697ARMDOptometrist
3126TNMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-State Optical Center, PLLC Optometrist CurrentSince Feb 1, 2016 Accepting new patients

Locations

1401 W Walnut St
Rogers, AR 72756
Phone (479) 636-2012

1714 W Walnut St
Rogers, AR 72756
Phone (479) 636-2012

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1374969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551139200000",
    "number": "1720420037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 NATCHEZ PT APT 27",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381030953",
            "telephone_number": "479-903-2411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 W WALNUT ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727563317",
            "telephone_number": "479-636-2012",
            "fax_number": "479-631-7416"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "650 New York St",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381045536",
            "country_code": "US",
            "telephone_number": "901-728-5858",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KINDY",
        "first_name": "ERIN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-28",
        "last_updated": "2019-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "3126",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogers, AR

Sources for this page

Verify at the official NPI Registry.