Individual provider Active NPI

Laureen Marie Kirkness, O.D.

  • Optometrist
  • Ft.Bliss, TX
National Provider Identifier
1902999154
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3113 Issued in WA
Practice address
East Bliss Clinic
21227 Torch St., Biggs Field
Ft.Bliss, TX 79918
Phone
(915) 742-9975
NPI assigned
Oct 2, 2006
Last updated
Mar 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618001811 VA
Optometrist 152W00000X 2943 CO
Optometrist 152W00000X 3113 WA Primary
Optometrist 152W00000X 3674 MA

Addresses

Primary practice location

East Bliss Clinic
21227 Torch St., Biggs Field
Ft.Bliss, TX 79918

Mailing address

East Bliss Clinic
21227 Torch St., Biggs Field
Ft.Bliss, TX 79918
Phone (915) 742-9975

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2943COMDCounselor
0618001811VAMDOptometrist
3113WAMDOptometrist
3674MAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1902999154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "EAST BLISS CLINIC",
            "address_2": "21227 TORCH ST., BIGGS FIELD",
            "city": "FT.BLISS",
            "state": "TX",
            "postal_code": "79918",
            "telephone_number": "915-742-9975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EAST BLISS CLINIC",
            "address_2": "21227 TORCH ST., BIGGS FIELD",
            "city": "FT.BLISS",
            "state": "TX",
            "postal_code": "79918",
            "telephone_number": "915-742-9975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRKNESS",
        "first_name": "LAUREEN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001811",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2943",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "3113",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "3674",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; 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.