Kerry Head and Associates

Primary specialty

OptometristTaxonomy code 152W00000X

License

046008928 Issued in IL

Legal business name

KERRY HEAD AND ASSOCIATES

Practice address

730 Tenney St
Wal-Mart Vision Center
Kewanee, IL 61443-3702

Phone

(309) 853-2302

Fax

(309) 853-3015

NPI assigned

Feb 10, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Kerry H Head, ODNPI 1902993652

Title

Optomotrist

Phone

(309) 853-2302

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kerry Howard Head, OD

  • Optometrist
  • Kewanee, IL
  • NPI 1902993652
  NPD (past) Authorized official

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

{
    "created_epoch": "1328832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328832000000",
    "number": "1770856437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 TENNEY ST",
            "address_2": "WAL-MART VISION CENTER",
            "city": "KEWANEE",
            "state": "IL",
            "postal_code": "614433702",
            "telephone_number": "309-853-2302",
            "fax_number": "309-853-3015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 TENNEY ST",
            "address_2": "WAL-MART VISION CENTER",
            "city": "KEWANEE",
            "state": "IL",
            "postal_code": "614433702",
            "telephone_number": "309-853-2302",
            "fax_number": "309-853-3015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KERRY HEAD AND ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-10",
        "last_updated": "2012-02-10",
        "status": "A",
        "authorized_official_last_name": "HEAD",
        "authorized_official_first_name": "KERRY",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OPTOMOTRIST",
        "authorized_official_telephone_number": "309-853-2302",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046008928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046008928",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mika Lynn Johnson, APRN, CNP
• Sheena Johnson
• JTCS Towing & Recovery LLC
• K-Town Taxi
• Susan Marie Kaufman, D.C.
• Kewanee Community Unit 229
• Kewanee Hco, LLC
• Kewanee Hco, LLC
• Kewanee Hospital
• Kewanee Hospital

• Optometrist in Kewanee, IL
• Providers in Kewanee, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2012; 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.