Provider Type Icon

KEVIN ROBERT KICKHAM OD NPI 1912113713


NPI Information

NPI: 1912113713
Provider Name: KEVIN ROBERT KICKHAM, OD
Classification: Optometrist - 152W00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
1308 E BATTLEFIELD
SPRINGFIELD, MO
ZIP 65804
Phone: (417) 890-7599
Get Directions

Kevin Robert Kickham, OD is an optometrist in Springfield, MO. The provider is 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. Kevin Robert Kickham, OD NPI is 1912113713. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1308 E BATTLEFIELD
SPRINGFIELD, MO
ZIP 65804
Phone: (417) 890-7599
Fax: (417) 886-6484

The NPI 1912113713 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 5/16/2007 and was last updated on 7/11/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1152W00000XOptometristT02770MISSOURIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1P00256828OTHERMISSOURIRAILROAD MEDICARE
2315387803MEDICAIDMISSOURI
3U30760MEDICARE UPIN
4256104298MEDICARE ID-TYPE UNSPECIFIEDMISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.