DR. TODD ALAN KENMORE (NPI# 1508870437) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508870437 |
| Entity Type | Individual |
| Full Name | DR. TODD ALAN KENMORE |
| Credential | O.D. |
| Practice Address |
513 N Telephone Rd Moore OK 73160-4938 |
| Practice Telephone | 4057993030 |
| Practice Fax Number | 4057993737 |
| Mailing Telephone | 4057993030 |
| Mailing Fax Number | 4057993737 |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2008-02-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 2366 | OK | Eye and Vision Services Providers |
| N | 152WC0802X |
Optometrist Specialization: Corneal and Contact Management |
2366 | OK | Eye and Vision Services Providers |
| N | 152WL0500X |
Optometrist Specialization: Low Vision Rehabilitation |
2366 | OK | Eye and Vision Services Providers |
| N | 152WP0200X |
Optometrist Specialization: Pediatrics |
2366 | OK | Eye and Vision Services Providers |
| N | 152WS0006X |
Optometrist Specialization: Sports Vision |
2366 | OK | Eye and Vision Services Providers |
| N | 152WV0400X |
Optometrist Specialization: Vision Therapy |
2366 | OK | Eye and Vision Services Providers |
| N | 152WX0102X |
Optometrist Specialization: Occupational Vision |
2366 | OK | Eye and Vision Services Providers |
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | 2366 | OK | Suppliers |
| N | 332H00000X | Eyewear Supplier (Equipment, not the service) | 2366 | OK | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | TAX ID | 010814058 | 01 |
| OK | 200019180B | 05 |
| Street Address |
513 N TELEPHONE RD |
| City | MOORE |
| State | OK |
| Zip Code | 73160-4938 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356524011 | Kenmore Eyecare Center | Durable Medical Equipment & Medical Supplies | 513 N Telephone Rd, Moore, OK 73160-4938 | 2007-12-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225678576 | Crystal Amanda Pitts | Student in an Organized Health Care Education/Training Program | 628 Allison Ln, Moore, OK 73160 | 2020-01-14 |
| 1982247623 | Tammie Lee Haworth | Occupational Therapy Assistant | Quest, 400 N Eastern Ave, Moore, OK 73160 | 2019-10-25 |
| 1477102580 | Php Management Group, LLC | Non-Pharmacy Dispensing Site | 1110 Magnolia Court, Moore, OK 73160 | 2019-09-11 |
| 1477117893 | Pharmology Moore LLC | Pharmacy | 1280 N Eastern Ave, Suite F, Moore, OK 73160 | 2019-05-01 |
| 1154891943 | Leah Cordell | Nurse Practitioner | 1280 North Eastern Ave., Suite F, Moore, OK 73160 | 2018-12-05 |
| 1467962332 | Healthcare Express, LLP | Clinic/Center | 551 Se 4th Street, Moore, OK 73160 | 2017-10-05 |
| 1306379557 | Dicarlo Venegas | Behavior Technician | 716 Wood Hollow Ln, Moore, OK 73160 | 2017-04-05 |
| 1073050167 | Tyron Dorrell Cosby Sr. | Case Manager/Care Coordinator | 1416 Penn Ln., Moore, OK 73160 | 2017-01-26 |
| 1326592650 | Kristin Kelley | Counselor | 1113 S Avery Dr, Moore, OK 73160 | 2016-08-03 |
| 1376912600 | Allison Kay Griffiths | Counselor | 9501 S. I-35 Service Rd, Apt 1504, Moore, OK 73160 | 2015-09-16 |
| Find all providers in zip 73160 | ||||
| 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 |
|---|---|---|---|---|
| 1265726301 | Massengale Eye Care, Pllc | Optometrist | 2828 N Broadway St, Moore, OK 73160-4304 | 2011-06-07 |
| 1891978748 | Courtney Kensing Humphrey | Optometrist | 2624 Se 8th St, Moore, OK 73160-6730 | 2007-12-14 |
| 1679799027 | Philip Edward Whitlow | Optometrist | 1313 Lawton, Moore, OK 73160-3636 | 2007-04-17 |
| 1083763072 | Lisa L Mayes | Optometrist | 705 Sw 19th St Ste 160b, Moore, OK 73160 | 2007-01-09 |
| 1679585566 | Jon E Painter | Optometrist | 619 N Broadway St, Moore, OK 73160-4813 | 2006-08-12 |
| 1992729909 | Curt Leroy Massengale | Optometrist | 2828 N. Broadway Avenue, Moore, OK 73160 | 2006-07-26 |
| 1396790671 | Orlando A Diaz | Optometrist | 660 Sw 19th St Ste G, Moore, OK 73160-5406 | 2006-05-24 |
| 1245215524 | Gary Lee Wade | Optometrist | 306 Se 4th St, Moore, OK 73160-6707 | 2005-12-09 |
| 1538151337 | Lance L. Ledbetter | Optometrist | 626 Nw 7th St, Moore, OK 73160-3804 | 2005-08-17 |
| 1497750251 | Max D Venard | Optometrist | 705 City Ave, Moore, OK 73160-3819 | 2005-06-17 |
| Find all providers in MOORE | ||||
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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.