DRS Driver & Clark PA
Organization Active NPI Optometrist · Salina, KS
NPI 1811076060 · NPPES record last updated Jun 20, 2008
Key facts
- NPI
- 1811076060
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- KS1325 (KS)
- Legal business name
- DRS DRIVER & CLARK PA
- Practice address
- 1601 E Iron Ave
Salina, KS 67401-3237 - Phone
- (785) 825-4679
- Fax
- (785) 825-5898
- NPI assigned
- Nov 6, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Kenton Ray Driver, OD
- Title
- Doctor
- Phone
- (785) 825-4679
Other NPIs on the same Medicare enrollment 1
Subparts reporting this organization as parent 1
Practitioners 4
-
Jenee' Barth, O.D.
-
Stacy Ann Clark, OD
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| DRS Driver & Clark PA |
Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses | Accepts assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in KS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040204000857 | KS | Part B Supplier - Clinic/Group Practice | 7416840392 |
Receives reassigned benefits from 4 practitioners 1 other NPI on this enrollment Practice locations: Minneapolis, KS; Salina, KS |
| O20100930003603 | KS | DME Supplier - Physician - Optometrist | 7416840392 | Practice locations: Salina, KS |
National Provider Directory
Locations
1100 W South St
Salina, KS 67401
Phone (785) 825-4679
1601 E Iron Ave
Salina, KS 67401
Phone (785) 525-4679
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | KS1325 | KS | Yes |
Addresses
Primary practice location
1601 E Iron Ave
Salina, KS 67401-3237
Mailing address
1601 E Iron Ave
Salina, KS 67401-3237
Phone (785) 825-4679
Other names
- Drs Driver & Clark, Optometrist, P.A.
Other providers in Salina, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 20, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.