KEVIN B. WYNNE, O.D. (NPI# 1275658924) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275658924 |
| Entity Type | Organization |
| Organization Name | KEVIN B. WYNNE, O.D. |
| Practice Address |
1524 Culver Rd Rochester NY 14609-4241 |
| Practice Telephone | 5856549200 |
| Mailing Telephone | 5856549200 |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. KEVIN BRADLEY WYNNE (OPTOMETRIST) |
| Authorized Official Telephone | 5856549200 |
| Authorized Official Credential | O.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332H00000X | Eyewear Supplier (Equipment, not the service) | V005374 | NY | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | BLUE CHOICE GROUP NUMBER | G0187194590 | 01 |
| Street Address |
1524 CULVER RD |
| City | ROCHESTER |
| State | NY |
| Zip Code | 14609-4241 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871083345 | Eye Appeal Masters In Vision LLC | Technician/Technologist | 1524 Culver Rd, Rochester, NY 14609-4241 | 2018-05-10 |
| 1902039159 | Mark Mastro | Technician/Technologist | 1524 Culver Rd, Rochester, NY 14609-4241 | 2009-09-03 |
| 1699926394 | Eye Appeal Masters In Vision LLC | Technician/Technologist | 1524 Culver Rd, Rochester, NY 14609-4241 | 2008-10-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154928828 | Aundrea Camille Williams | Licensed Practical Nurse | 99 Meaodw Circle, Rochester, NY 14609 | 2020-10-06 |
| 1043836869 | Sharon Ann Reilly | Registered Nurse | 910 North Goodman Street, Suite 1, Rochester, NY 14609 | 2020-06-17 |
| 1235655671 | Tameka Shaunte Parker | Licensed Practical Nurse | 35 Village Way, Rochester, NY 14609 | 2017-08-17 |
| 1851817472 | Mary Ann Dukes | Registered Nurse | 75 Yates Street, Rochester, NY 14609 | 2017-08-15 |
| 1023533064 | Fernando Caumont | Urology | 2615 Culver Rd Ste 100, Rochester, NY 14609 | 2017-08-10 |
| 1083061162 | Teyanee Latavia Harewood | Registered Nurse | 418 Hayward Ave, Rochester, NY 14609 | 2016-05-19 |
| 1164853891 | Sukhminder Kaur Sahansra | Internal Medicine | 335 North Park Drive, Elderone, Rochester, NY 14609 | 2013-12-05 |
| 1952749863 | Nada Jadrovska | Registered Nurse | 79 Eagle Rock Dr, Rochester, NY 14609 | 2013-06-13 |
| 1457602930 | Lynnetta Maria Hollomon | Licensed Practical Nurse | 827 Edgecreek Trail, Rochester, NY 14609 | 2012-09-25 |
| 1568711596 | Anthony L. Jordan Health Corporation | Clinic/Center | 151 Parsells Ave, Jordan Health At Community Place, Rochester, NY 14609 | 2012-09-06 |
| Find all providers in zip 14609 | ||||
| Taxonomy Code | 332H00000X |
| Grouping | Suppliers |
| Classification | Eyewear Supplier (Equipment, not the service) |
| An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033717277 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 300 Bellwood Dr, Rochester, NY 14606-4262 | 2020-10-10 |
| 1053977421 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1620 Broadway Ave S Ste 4, Rochester, MN 55904-7927 | 2019-05-11 |
| 1740633031 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 2854 41st St Nw, Suite 103, Rochester, MN 55901-7825 | 2016-07-21 |
| 1588036479 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 600 Jefferson Rd, Suite 3, Rochester, NY 14623-3230 | 2015-10-30 |
| 1396139838 | Strong Optical Shop | Eyewear Supplier (Equipment, not the service) | 1317 Mount Hope Ave, Rochester, NY 14620-3923 | 2015-03-23 |
| 1538553268 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 335 Westfall Road, Rochester, NY 14620 | 2015-03-19 |
| 1962801878 | The Association for The Blind and Visually Impaired - Goodwill Industr | Eyewear Supplier (Equipment, not the service) | 500 S Clinton Ave, Rochester, NY 14620-1198 | 2014-08-15 |
| 1316271695 | Highlander Healthcare Supply Services Inc | Eyewear Supplier (Equipment, not the service) | 847 Goodman St S, Rochester, NY 14620-2523 | 2009-09-20 |
| 1700018363 | Kls Optical Inc. | Eyewear Supplier (Equipment, not the service) | 215 Elton Hills Dr Nw, #26, Rochester, MN 55901-2482 | 2009-08-17 |
| 1891982724 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 4611 Main Ave Se, Rochester, MN 55904-5904 | 2007-09-25 |
| Find all providers in ROCHESTER | ||||
Please comment or provide details below to improve the information on KEVIN B. WYNNE, O.D..
| 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.