Individual provider Active NPI

Kimberly Blythe McPherson, O.D.

  • Optometrist
  • Westlake, TX
National Provider Identifier
1881075927
Registry record updated Feb 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8665TG Issued in TX
Practice address
72 Andorra Dr
Westlake, TX 76262
Phone
(817) 674-7500
NPI assigned
Jun 15, 2015
Last updated
Feb 6, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 8665TG TX Primary

Addresses

Primary practice location

72 Andorra Dr
Westlake, TX 76262

Mailing address

6113 Pleasant Dream St
North Richland Hills, TX 76180-7425
Phone (806) 277-0083

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20150831001631 TX Practitioner - Optometry 6103132584 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eyes on Westlake PLLCGroup PAC ID 9739590928, 2 clinicians

Practice addresses (Care Compare)

72 Andorra Dr
Suite 180
Westlake, TX 76262-2299
Phone (817) 674-7500

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8665TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eyes on Westlake, PLLC Optometrist CurrentSince Oct 16, 2020 Accepting new patients
Mdphillipsod PLLC Optometrist CurrentSince Nov 3, 2019 Accepting new patients

Locations

4012 Preston Rd
Ste 500
Plano, TX 75093
Phone (972) 985-3638

72 Andorra Dr
Westlake, TX 76262
Phone (817) 674-7500

72 Andorra Dr
Ste 180
Westlake, TX 76262
Phone (817) 674-7500

Organizations & group practices 2

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": "1434326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580947200000",
    "number": "1881075927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6113 PLEASANT DREAM ST",
            "city": "NORTH RICHLAND HILLS",
            "state": "TX",
            "postal_code": "761807425",
            "telephone_number": "806-277-0083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 ANDORRA DR",
            "city": "WESTLAKE",
            "state": "TX",
            "postal_code": "76262",
            "telephone_number": "817-674-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCPHERSON",
        "first_name": "KIMBERLY",
        "middle_name": "BLYTHE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-15",
        "last_updated": "2020-02-06",
        "certification_date": "2020-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8665TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westlake, TX

Sources for this page

Verify at the official NPI Registry.