Individual provider Active NPI

Kevin B. Cline, O.D.,FCOVD

  • Vision Therapy Optometrist
  • Wichita, KS
National Provider Identifier
1740393107
Registry record updated May 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vision Therapy OptometristTaxonomy code 152WV0400X
License
1295 Issued in KS
Practice address
12111 W Maple St
Wichita, KS 67235-8755
Phone
(316) 942-7496
Fax
(316) 239-2557
NPI assigned
Aug 17, 2006
Last updated
May 31, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1295 KS
Pediatric Optometrist 152WP0200X 1295 KS
Vision Therapy Optometrist 152WV0400X 1295 KS Primary

Addresses

Primary practice location

12111 W Maple St
Wichita, KS 67235-8755

Mailing address

415 SE Louis Dr
Mulvane, KS 67110-1205
Phone (316) 777-0022

Other practice location 1

415 SE Louis Dr
Mulvane, KS 67110-1205
Phone (316) 942-7496

Other practice location 2

2635 W Douglas Ave
Wichita, KS 67213-2605
Phone (316) 942-7496

Other practice location 3

2330 N Amidon Ave
Wichita, KS 67204-5630
Phone (316) 942-7496

Other identifiers 1

IdentifierTypeStateIssuer
100218790CMedicaidKS

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20050927000909 KS Practitioner - Optometry 0840224101 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wichita Optometry, P.a.Group PAC ID 2567541451, 11 clinicians

Practice addresses (Care Compare)

2635 W Douglas Ave
Wichita, KS 67213-2605
Phone (316) 942-7496

Merit-based Incentive Payment System (MIPS)

Final score
90.45 of 100Reported as group
Quality
80.9
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wichita Optometry, P.a. Optometrist CurrentSince Jun 1, 2018 Accepting new patients
Wichita Optometry P.a. Optometrist CurrentSince Jun 1, 2018 Accepting new patients
DRS Price Young Odle & Horsch PA Optometrist Past Accepting new patients
DRS Price Young Odle & Horsch PA Optometrist Past Accepting new patients

Locations

415 SE Louis Dr
Mulvane, KS 67110
Phone (316) 777-0022

12111 W Maple St
Ste 125
Wichita, KS 67235
Phone (316) 832-0026

2330 N Amidon Ave
Wichita, KS 67204
Phone (316) 838-7797

2635 W Douglas Ave
Wichita, KS 67213
Phone (316) 942-7496

7015 E Central Ave
Ste 2
Wichita, KS 67206
Phone (316) 440-8800

Organizations & group practices 6

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": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527724800000",
    "number": "1740393107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 SE LOUIS DR",
            "city": "MULVANE",
            "state": "KS",
            "postal_code": "671101205",
            "telephone_number": "316-777-0022",
            "fax_number": "316-777-4342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12111 W MAPLE ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672358755",
            "telephone_number": "316-942-7496",
            "fax_number": "316-239-2557"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "415 SE Louis Dr",
            "address_purpose": "LOCATION",
            "city": "Mulvane",
            "state": "KS",
            "postal_code": "671101205",
            "country_code": "US",
            "telephone_number": "316-942-7496",
            "fax_number": "316-942-7496",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2635 W Douglas Ave",
            "address_purpose": "LOCATION",
            "city": "Wichita",
            "state": "KS",
            "postal_code": "672132605",
            "country_code": "US",
            "telephone_number": "316-942-7496",
            "fax_number": "316-239-2557",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2330 N Amidon Ave",
            "address_purpose": "LOCATION",
            "city": "Wichita",
            "state": "KS",
            "postal_code": "672045630",
            "country_code": "US",
            "telephone_number": "316-942-7496",
            "fax_number": "316-239-2557",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLINE",
        "first_name": "KEVIN",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "O.D.,FCOVD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2018-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1295",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "KS",
            "license": "1295",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "KS",
            "license": "1295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100218790C",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.