KEVIN R KICKHAM LLC (NPI# 1548476344) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548476344 |
| Entity Type | Organization |
| Organization Name | KEVIN R KICKHAM LLC |
| Practice Address |
1308 E Battlefield Springfield MO 65804 |
| Mailing Address |
1308 E Battlefield St Springfield MO 65804-3604 |
| Practice Telephone | 4178907599 |
| Practice Fax Number | 4178866484 |
| Mailing Telephone | 4178907599 |
| Mailing Fax Number | 4178866484 |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2016-02-05 |
| Authorized Official Name | KEVIN ROBERT KICKHAM (OPTOMETRIST OWNER) |
| Authorized Official Telephone | 4178907599 |
| Authorized Official Credential | OD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | T02770 | MO | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | MEDICARE PTAN | 000014298 | 01 |
| MO | RAILROAD MEDICARE | P00256828 | 01 |
| MO | 315387803 | 05 |
| Street Address |
1308 E BATTLEFIELD |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912113713 | Kevin Robert Kickham | Optometrist | 1308 E Battlefield, Springfield, MO 65804 | 2007-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790393049 | Kathy Forson | Nurse Practitioner | 1235 E. Cherokee St., Springfield, MO 65804 | 2020-07-22 |
| 1306498779 | Anne B Summers, LLC | Social Worker | 1310 E. Kingsley St., Ste C, Springfield, MO 65804 | 2019-07-15 |
| 1790241800 | Margaret Mary Hart | Social Worker | 1845 S Rogers Ave, Springfield, MO 65804 | 2019-02-13 |
| 1598254666 | Casey Carr | Optometrist | 1229 E Seminole St Ste 110, Springfield, MO 65804 | 2018-05-04 |
| 1124520697 | Shelby D White | Behavioral Analyst | 1300 E. Bradford Parkway, Springfield, MO 65804 | 2018-03-01 |
| 1316448343 | Karl Lynham | Massage Therapist | 1200 E Woodhurst Dr R300, Springfield, MO 65804 | 2018-02-25 |
| 1699273763 | Leah Wilson | Counselor | 1322 E Woodgate, Springfield, MO 65804 | 2018-01-24 |
| 1295242626 | Matthew Crisp | Physical Therapist | 3252 E Independence St, Springfield, MO 65804 | 2018-01-08 |
| 1518491042 | Crystal Spangler | Dietitian, Registered | 1965 S Fremont Ave Ste 220, Springfield, MO 65804 | 2017-04-11 |
| 1588012033 | Jeffrey Williams | Pharmacist | 1235 E. Cherokee, Springfield, MO 65804 | 2016-05-25 |
| Find all providers in zip 65804 | ||||
| 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 |
|---|---|---|---|---|
| 1053938092 | Premier Vision Center LLC | Optometrist | 2809 Mansion Rd Ste A, Springfield, IL 62711-6811 | 2020-06-25 |
| 1376180109 | Drs. Akre & Clark, Ltd. | Optometrist | 623 W Rock St, Springfield, MN 56087-1028 | 2019-11-27 |
| 1407410087 | Missouri Physicians Eyecare Group, P.C. | Optometrist | 1415 E Battlefield St, Springfield, MO 65804-3701 | 2019-04-29 |
| 1467931006 | Vision Care Focus, LLC | Optometrist | 1507 Mohawk Blvd, Springfield, OR 97477-3355 | 2018-08-13 |
| 1306337126 | Casey Marie Smith | Optometrist | 1024 N Plum St, Springfield, OH 45504-2108 | 2018-05-29 |
| 1598254666 | Casey Carr | Optometrist | 1229 E Seminole St Ste 110, Springfield, MO 65804 | 2018-05-04 |
| 1790299311 | Springfield Eye Specialists LLC | Optometrist | 3231 S National Ave Ste 165, Springfield, MO 65807-7304 | 2017-11-17 |
| 1093253247 | Minh-tam Nguyen | Optometrist | 8424 Old Keene Mill Rd, Springfield, VA 22152-2302 | 2017-02-08 |
| 1013453877 | Grace Chang, Od PC | Optometrist | 6575n Frontier Dr, Springfield, VA 22150-1415 | 2017-01-17 |
| 1669821914 | Laura Kay | Optometrist | 1342 E Primrose St Ste B, Springfield, MO 65804-4224 | 2016-06-08 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 65804 |
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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.