John D Kastl, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OK936 Issued in OK

Practice address

4901 N Kickapoo Ave
Suite#1606
Shawnee, OK 74804-1303

Phone

(405) 273-5014

Fax

(405) 273-5014

NPI assigned

Nov 22, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881769008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4901 N KICKAPOO AVE",
            "address_2": "SUITE#1606",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748041303",
            "telephone_number": "405-273-5014",
            "fax_number": "405-273-5014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 N KICKAPOO AVE",
            "address_2": "SUITE#1606",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748041303",
            "telephone_number": "405-273-5014",
            "fax_number": "405-273-5014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASTL",
        "first_name": "JOHN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "OK936",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "OK936",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Shawnee, OK
• Providers in Shawnee, OK by specialty
• Optometrist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.