Organization Active NPI

Kent Kneip OD PLLC

  • Optometrist
  • Gilbert, AZ
National Provider Identifier
1891964284
Registry record updated Aug 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
630 Issued in AZ
Legal business name
KENT KNEIP OD PLLC
Practice address
1425 S Higley Rd Ste 103
Gilbert, AZ 85296-4798
Phone
(480) 840-6888
Fax
(480) 840-3361
NPI assigned
Feb 29, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2009

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

Authorized official

Name
Mrs. Gabriella Victorio
Title
Manager/Optician
Phone
(480) 840-6888

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 630 AZ Primary

Addresses

Primary practice location

1425 S Higley Rd Ste 103
Gilbert, AZ 85296-4798

Mailing address

1425 S Higley Rd Ste 103
Gilbert, AZ 85296-4798
Phone (480) 840-6888

Other names 1

  • Neighborhood Vision Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060324000234 AZ Part B Supplier - Clinic/Group Practice 8729096219 Receives reassigned benefits from 1 practitioner
Practice locations: Gilbert, AZ

National Provider Directory

National Provider Directory

Locations

1425 S Higley Rd
Ste 103
Gilbert, AZ 85296
Phone (480) 840-6888

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1204243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249516800000",
    "number": "1891964284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 S HIGLEY RD STE 103",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852964798",
            "telephone_number": "480-840-6888",
            "fax_number": "480-840-3361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 S HIGLEY RD STE 103",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852964798",
            "telephone_number": "480-840-6888",
            "fax_number": "480-840-3361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENT KNEIP OD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-29",
        "last_updated": "2009-08-06",
        "status": "A",
        "authorized_official_last_name": "VICTORIO",
        "authorized_official_first_name": "GABRIELLA",
        "authorized_official_title_or_position": "MANAGER/OPTICIAN",
        "authorized_official_telephone_number": "480-840-6888",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Neighborhood Vision Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.