DR. KURTIS M. CARLSON (NPI# 1104930601) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104930601 |
| Entity Type | Individual |
| Full Name | DR. KURTIS M. CARLSON |
| Credential | O.D. |
| Practice Address |
4929 Oak Street Quincy IL 62305-2839 |
| Mailing Address |
4929 Oak Street Quincy IL 62305 |
| Practice Telephone | 2172222020 |
| Practice Fax Number | 2172239582 |
| Mailing Telephone | 2172222020 |
| Mailing Fax Number | 2172239582 |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2015-05-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 046-008272 | IL | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS BLUE SHIELD | 132031 | 01 |
| IL | HEALTHLINK | 258761 | 01 |
| Street Address |
4929 OAK STREET |
| City | QUINCY |
| State | IL |
| Zip Code | 62305-2839 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205006079 | 20 20 Eyecare Inc | Durable Medical Equipment & Medical Supplies | 4929 Oak Street, Quincy, IL 62305 | 2008-03-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386999001 | Kristi Michelle Gillette | Internal Medicine | 5011 Oak St, Quincy, IL 62305 | 2012-07-18 |
| 1447582549 | Cathi Marie Webb | Counselor | 3701 E Lake Center Dr, Suite # 8 The Shaw Building, Quincy, IL 62305 | 2010-02-01 |
| 1285804450 | Curtis D Fauble | Dentist | 4561 Maine, Quincy, IL 62305 | 2008-03-04 |
| 1598940256 | Kelley Jo Begeman | Licensed Practical Nurse | 934 North 1903 Road Lane, Quincy, IL 62305 | 2007-12-31 |
| 1649459470 | Aa Dental Care PC | Dentist | 407 So 48th Street, Quincy, IL 62305 | 2007-10-29 |
| 1982803920 | Dennis Ryan Wagner | Dentist | 407 South 48th St, Quincy, IL 62305 | 2007-07-11 |
| 1689899056 | Capelle House | Day Training, Developmentally Disabled Services | 3325 Ghost Hollow Road, Quincy, IL 62305 | 2007-04-13 |
| 1750416236 | Julie A Danker | Social Worker | 2209 N 64th St, Quincy, IL 62305 | 2007-02-23 |
| 1942812300 | Brooke N Bracy | Dentist | 4561 Maine, Quincy, IL 62305 | 2020-08-18 |
| 1558997379 | Blessing Corporate Services, Inc | Clinic/Center | 4800 Maine St, Quincy, IL 62305 | 2020-03-13 |
| Find all providers in zip 62305 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083095806 | Mary Bui Vo | Optometrist | 1219 Hancock St, Quincy, MA 02169-4342 | 2015-06-17 |
| 1356775720 | Jason Michael Kvitle | Optometrist | 3325 Maine St, Suite 1, Quincy, IL 62301-4438 | 2013-08-21 |
| 1164855698 | Phuong Thanh Nguyen | Optometrist | 212 Common St, Quincy, MA 02169-4709 | 2013-08-20 |
| 1053684027 | Sandra M. Payton Vision Care, Inc | Optometrist | 1147 Hancock St Ste E, Quincy, MA 02169-4330 | 2012-02-21 |
| 1760715999 | Anjali Pathak | Optometrist | 10 Faxon Ave, 114, Quincy, MA 02169-4682 | 2009-09-04 |
| 1265689863 | Bobak Rafati | Optometrist | 3131 Broadway, Quincy, IL 62301 | 2008-08-26 |
| 1831381045 | Comfort Vision Inc | Optometrist | 221 Quincy Ave Unit B, Quincy, MA 02169-6754 | 2007-08-11 |
| 1275731655 | Jonathan Charles Friden | Optometrist | 68 E Central Ave Ste C, Quincy, CA 95971-9718 | 2007-07-06 |
| 1922120781 | Usana Wu | Optometrist | 200 Cove Way, #504, Quincy, MA 02169-5882 | 2007-04-04 |
| 1730214552 | Dr Sheldon Strauss | Optometrist | 675 Hancock St, Quincy, MA 02170-2826 | 2007-02-22 |
| Find all providers in QUINCY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.