Active NPI
James D Herndon, O.D.
- Optometrist
- Wichita, KS
National Provider Identifier
1912979188
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1237-2
- Practice address
- 1202 W Maple St
Wichita, KS 67213-3916 - Phone
- (316) 262-3716
- Fax
- (316) 262-0784
- NPI assigned
- Feb 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1237-2 | KS | Primary |
Addresses
Primary practice location
1202 W Maple St
Wichita, KS 67213-3916
Mailing address
1202 W Maple St
Wichita, KS 67213-3916
Phone (316) 262-3716
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 005347 | Other | KS | BCBS |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1237-2 | KS | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138838400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1218499200000",
"number": "1912979188",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1202 W MAPLE ST",
"city": "WICHITA",
"state": "KS",
"postal_code": "672133916",
"telephone_number": "316-262-3716",
"fax_number": "316-262-0784"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1202 W MAPLE ST",
"city": "WICHITA",
"state": "KS",
"postal_code": "672133916",
"telephone_number": "316-262-3716",
"fax_number": "316-262-0784"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERNDON",
"first_name": "JAMES",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-02",
"last_updated": "2008-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "KS",
"license": "1237-2",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "005347",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wichita, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 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.