Mitchel Steven Kemp, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

18004409A Issued in IN

Practice address

2030 S Reed Rd
Kokomo, IN 46902-1905

Phone

(765) 455-1644

NPI assigned

Jun 12, 2023

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

Medicare fee-for-service enrollment

Enrolled in IN

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

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

PHB Vision Group, P.C.Group PAC ID 5193200517, 4 clinicians

Practice addresses (Care Compare)

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.

• PHB Vision Group, P.C.

  • Optometrist
  • Fort Wayne, IN
  • NPI 1346105723
  Medicare reassignment Care Compare group
• Wisconsin Vision, Inc

  • Optometrist
  • Indianapolis, IN
  • NPI 1245378348
  NPD
• Wisconsin Vision, LLC

  • Optometrist
  • New Berlin, WI
  • NPI 1134179427
  NPD
• Wisconsin Vision, LLC

  • Optometrist
  • Brookfield, WI
  • NPI 1457890220
  NPD

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

{
    "created_epoch": "1686528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1902580863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 ALED LN",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463838927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 S REED RD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469021905",
            "telephone_number": "765-455-1644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEMP",
        "first_name": "MITCHEL",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-12",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18004409A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Keegan
• Molly Keenan
• Nathaniel David Keene
• Olivia Keith
• Jessica Kelly, CCC, SLP
• Skylar Kemp
• Ryan Matthew Kendall
• Michelle Kennedy
• Christina Rachel Kenner, MASSAGE THERAPIST
• Kerenza Kent, RBT

• Optometrist in Kokomo, IN
• Providers in Kokomo, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; 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.