Individual provider Active NPI

Kollin Lamar Klingenberg, OD

  • Optometrist
  • Wake Forest, NC
National Provider Identifier
1962319558
Registry record updated Aug 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2925 Issued in NC
Practice address
3150 Rogers Rd Ste 110
Wake Forest, NC 27587-4196
Phone
(919) 263-9163
Fax
(919) 263-9408
NPI assigned
Aug 27, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2925 NC Primary

Addresses

Primary practice location

3150 Rogers Rd Ste 110
Wake Forest, NC 27587-4196

Mailing address

3150 Rogers Rd Ste 110
Wake Forest, NC 27587-4196
Phone (919) 263-9163

Medicare participation

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

NPI Registry JSON

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

{
    "created_epoch": "1787788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787788800000",
    "number": "1962319558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3150 ROGERS RD STE 110",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275874196",
            "telephone_number": "919-263-9163",
            "fax_number": "919-263-9408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3150 ROGERS RD STE 110",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275874196",
            "telephone_number": "919-263-9163",
            "fax_number": "919-263-9408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLINGENBERG",
        "first_name": "KOLLIN",
        "middle_name": "LAMAR",
        "name_prefix": "Mr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-08-27",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wake Forest, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.