Kevin a. Harry, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

WI 2179 Issued in WI

Legal business name

KEVIN A. HARRY, O.D.

Practice address

17125 W Bluemound Rd
Suite F
Brookfield, WI 53005-5948

Phone

(262) 786-9630

Fax

(262) 786-3972

NPI assigned

May 19, 2007

Organization subpart

No

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

Authorized official

Name

Kevin Allen Harry, OD

Title

Owner-Optometrist

Phone

(262) 786-9630

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Signature Eyecare Doing business as

Locations

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

{
    "created_epoch": "1179532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213228800000",
    "number": "1902014277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17125 W BLUEMOUND RD",
            "address_2": "SUITE F",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530055948",
            "telephone_number": "262-786-9630",
            "fax_number": "262-786-3972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17125 W BLUEMOUND RD",
            "address_2": "SUITE F",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530055948",
            "telephone_number": "262-786-9630",
            "fax_number": "262-786-3972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN A. HARRY, O.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-19",
        "last_updated": "2008-06-12",
        "status": "A",
        "authorized_official_last_name": "HARRY",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "OWNER-OPTOMETRIST",
        "authorized_official_telephone_number": "262-786-9630",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WI",
            "license": "WI 2179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38575400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Signature Eyecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optometrist in Brookfield, WI
• Providers in Brookfield, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2008; 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.