Sam Chadwell Kang, O.D. (OPTOMETRIST)

Primary specialty

OptometristTaxonomy code 152W00000X

License

02295 Issued in IA

Practice address

3601 29TH Ave SW
Cedar Rapids, IA 52404-3109

Phone

(319) 390-9969

NPI assigned

Jan 17, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IA

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

Illinois College of Optometry at Chicago, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214524800000",
    "number": "1922088038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 29TH AVE SW",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524043109",
            "telephone_number": "319-390-9969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 29TH AVE SW",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524043109",
            "telephone_number": "319-390-9969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANG",
        "first_name": "SAM",
        "middle_name": "CHADWELL",
        "name_prefix": "Dr.",
        "credential": "O.D. (OPTOMETRIST)",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2008-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "02295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTOMETRY",
            "identifier": "WELLMARK 38635",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel Kain, M.S., BCBA, LBA
• Barbara Ellen Kalinsky, PT
• Leslie Joy Kalkhoff
• Krystyna Kaminski, LMSW
• Heidi Kanealy, PT
• Karly M. a. Kantarevic, DC
• Amy B Kapler, PAC
• Karen Davis, Lisw LLC
• Karen K. Wolf, DDS, Inc.
• Joseph Kariuki

• Optometrist in Cedar Rapids, IA
• Providers in Cedar Rapids, IA by specialty
• Optometrist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2008; 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.