Kivlin Eye Clinic, SC

Primary specialty

OptometristTaxonomy code 152W00000X

License

1539-035 Issued in WI

Legal business name

KIVLIN EYE CLINIC, SC

Practice address

370 3Rd Ave
Clear Lake, WI 54005

Phone

(715) 263-2600

Fax

(715) 263-3233

NPI assigned

Aug 28, 2007

Last updated

Aug 31, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. James B Kivlin, OD

Title

Owner/Optometrist

Phone

(715) 263-2600

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Douglas Michael Monette, OD

  • Optometrist
  • Menomonie, WI
  • NPI 1669460895
  NPD

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

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251676800000",
    "number": "1952595480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15",
            "address_2": "370 3RD AVE",
            "city": "CLEAR LAKE",
            "state": "WI",
            "postal_code": "54005",
            "telephone_number": "715-263-2600",
            "fax_number": "715-263-3233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 3RD AVE",
            "city": "CLEAR LAKE",
            "state": "WI",
            "postal_code": "54005",
            "telephone_number": "715-263-2600",
            "fax_number": "715-263-3233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIVLIN EYE CLINIC, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-28",
        "last_updated": "2009-08-31",
        "status": "A",
        "authorized_official_last_name": "KIVLIN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "715-263-2600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "1539-035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "0523040002",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38702400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deborah Sue Cuper, DPT
• Lisa Karen Dodge
• Stephanie L Fall, ATC
• Kyle John Fritz
• Kathy Ann Gates, FNP-C
• Kyle Anthony Larson, DPT
• Emily J Monson, MSPT
• Jolleen Mary Nichols, DNP
• Northern Roots Family Spinal Care, LLC
• Northland Audiology LLC

• Optometrist in Clear Lake, WI
• Providers in Clear Lake, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2009; 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.