Active NPI
Dale L Kaney, OD
- Optometrist
- Freeport, IL
National Provider Identifier
1982718482
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 46-6980
- Practice address
- 980 W South St
Freeport, IL 61032-6777 - Phone
- (815) 235-3466
- Fax
- (815) 235-1712
- NPI assigned
- Aug 19, 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 | 46-6980 | IL | Primary |
Addresses
Primary practice location
980 W South St
Freeport, IL 61032-6777
Mailing address
980 W South St
Freeport, IL 61032-6777
Phone (815) 235-3466
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 46-6980 | Medicaid | IL |
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 |
|---|---|---|---|
| 46-6980 | IL | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201478400000",
"number": "1982718482",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "980 W SOUTH ST",
"city": "FREEPORT",
"state": "IL",
"postal_code": "610326777",
"telephone_number": "815-235-3466",
"fax_number": "815-235-1712"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "980 W SOUTH ST",
"city": "FREEPORT",
"state": "IL",
"postal_code": "610326777",
"telephone_number": "815-235-3466",
"fax_number": "815-235-1712"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KANEY",
"first_name": "DALE",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-19",
"last_updated": "2008-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IL",
"license": "46-6980",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "46-6980",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Freeport, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 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.