Kenn J Kostelnik, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

TO2395 Issued in MO

Practice address

1518 E Battlefield St
Springfield, MO 65804-3704

Phone

(417) 881-5530

Fax

(417) 889-4071

NPI assigned

Mar 30, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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 and National Provider Directory roles.

• Om Vision Services Inc,

  • Clinic/Center
  • Columbia, MO
  • NPI 1316318280
  NPD (past)
• Om Vision Services Inc,

  • Clinic/Center
  • Springfield, MO
  • NPI 1528273927
  NPD (past)

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1831219260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1518 E BATTLEFIELD ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658043704",
            "telephone_number": "417-881-5530",
            "fax_number": "417-889-4071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1518 E BATTLEFIELD ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658043704",
            "telephone_number": "417-881-5530",
            "fax_number": "417-889-4071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSTELNIK",
        "first_name": "KENN",
        "middle_name": "J",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "TO2395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kordes Counseling LLC
• Katherine Kordes, MS PLPC
• Bradley A Korman, CRNA
• Erica Ashley Kosar, NP
• Kosma Mobile X-Ray Co., Inc.
• McKenzie Joy Kostreva, PA-C
• Totka R. Koutzeva-Dussel, MD
• Julia Kovalenko, HYG
• Karen Kovalik
• Helen Kozlov, FNP

• All providers in Springfield, MO
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.