Randall D Kittle, OD

Primary specialty

OptometristTaxonomy code 152W00000X

Practice address

4940 E State St
Ste 2
Rockford, IL 61108-2270

Phone

(815) 397-5959

NPI assigned

Mar 6, 2008

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

Enrolled in IL

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Christina J. Levi O D P C.Group PAC ID 9436210762, 63 clinicians

Stoneview Eye Care, LLCGroup PAC ID 5698175529, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Christina J. Levi O D P C

  • Optometrist
  • Edwardsville, IL
  • NPI 1477703411
  Medicare reassignment Care Compare group NPD
• Stoneview Eye Care, LLC

  • Optometrist
  • Roscoe, IL
  • NPI 1568042463
  Medicare reassignment Care Compare group NPD
• Christina J. Levi O D P C

  • Optometrist
  • Edwardsville, IL
  • NPI 1033261904
  NPD (past)

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

{
    "created_epoch": "1204761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204761600000",
    "number": "1871763839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6785 WEAVER RD",
            "address_2": "STE D",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611148055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4940 E STATE ST",
            "address_2": "STE 2",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082270",
            "telephone_number": "815-397-5959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITTLE",
        "first_name": "RANDALL",
        "middle_name": "D",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-06",
        "last_updated": "2008-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Robert Kirk, DC
• Jordin Marie Kirk
• Amy Kirsch, RN, MSN
• Lauren Kiselstein, PHARMD
• Benjamin Josiah Kittle
• Angela Kitts-Faron, APN
• Brian Klaung, LCSW MSW
• Paul J Klazura, M.D.
• Brittany Klein, FNP-BC
• Amelia Johanna Klemp, M.S. CCC-SLP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.