Individual provider Active NPI

Sheerlee Kuttner, OD

  • Optometrist
  • Rockville, MD
National Provider Identifier
1912193954
Registry record updated Sep 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA2037 Issued in MD
Practice address
11802 Rockville Pike Ste B
Rockville, MD 20852-2742
Phone
(301) 770-7780
Fax
(301) 770-1433
NPI assigned
Sep 24, 2007
Last updated
Sep 24, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA2037 MD Primary

Addresses

Primary practice location

11802 Rockville Pike Ste B
Rockville, MD 20852-2742

Mailing address

11103 West Ave
6
San Antonio, TX 78213-1370
Phone (210) 524-6509

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
TA2037MDMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1190592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190592000000",
    "number": "1912193954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11103 WEST AVE",
            "address_2": "6",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782131370",
            "telephone_number": "210-524-6509",
            "fax_number": "210-524-6527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11802 ROCKVILLE PIKE STE B",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208522742",
            "telephone_number": "301-770-7780",
            "fax_number": "301-770-1433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUTTNER",
        "first_name": "SHEERLEE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-24",
        "last_updated": "2007-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA2037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.