DR. CARLY JEAN KIOMALL (NPI# 1124549332) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124549332 |
| Entity Type | Individual |
| Full Name | DR. CARLY JEAN KIOMALL |
| Other Name | DR. CARLY JEAN GRONDIN |
| Credential | OD, MPH |
| Practice Address |
3500 Civic Center Blvd Philadelphia PA 19104-4395 |
| Mailing Address |
39 Belanger Ave Windham ME 04062-5051 |
| Practice Telephone | 2155902791 |
| Mailing Telephone | 2077560957 |
| Enumeration Date | 2017-06-28 |
| Last Update Date | 2020-05-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152W00000X | Optometrist | 27OA00684900 | NJ | Eye and Vision Services Providers |
| Y | 152W00000X | Optometrist | OEG003398 | PA | Eye and Vision Services Providers |
| N | 152W00000X | Optometrist | 008634 | NY | Eye and Vision Services Providers |
| Street Address |
3500 CIVIC CENTER BLVD |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19104-4395 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184672396 | Lisa Rosenthal Young | Internal Medicine | 3500 Civic Center Blvd, Philadelphia, PA 19104 | 2006-05-04 |
| 1699396598 | Melissa May Cunningham-hill | Nurse Practitioner | 3500 Civic Center Blvd, Philadelphia, PA 19104-4395 | 2020-05-01 |
| 1861012403 | Emily Janae Camacho | Audiologist | 3500 Civic Center Blvd, Philadelphia, PA 19104-4395 | 2020-04-23 |
| 1326678848 | Casey Adams | Nurse Practitioner | 3500 Civic Center Blvd, Philadelphia, PA 19104-4395 | 2020-01-23 |
| 1881230431 | Helena Calkap | Nurse Practitioner | 3500 Civic Center Blvd, Philadelphia, PA 19104-4395 | 2019-11-19 |
| 1568021699 | Jocelyn Kalkbrenner | Nurse Practitioner | 3500 Civic Center Blvd, Philadelphia, PA 19104-4395 | 2019-06-12 |
| 1083104418 | Stephanie Lauren Robbins | Pediatrics | 3500 Civic Center Blvd, Philadelphia, PA 19104-4395 | 2018-05-10 |
| 1487169587 | Megan Englehart | Nurse Practitioner | 3500 Civic Center Blvd, Philadelphia, PA 19104-4395 | 2017-12-11 |
| 1386189421 | Alexis Lipinski | Nurse Practitioner | 3500 Civic Center Blvd, Philadelphia, PA 19104-4395 | 2016-12-28 |
| 1891038774 | Stacey Diane Elkhatib Smidt | Psychiatry & Neurology | 3500 Civic Center Blvd, Philadelphia, PA 19104-4395 | 2013-03-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770829 | Michelle Morris | Student in an Organized Health Care Education/Training Program | Dept. of Family Medicine & Community Health, 3737 Market, Philadelphia, PA 19104 | 2020-11-04 |
| 1346853041 | Spectrum Health Services, Inc. | Clinic/Center | 1415 South University Ave, Philadelphia, PA 19104 | 2020-08-24 |
| 1770104259 | Fatimah Sorefan-mangou | Student in an Organized Health Care Education/Training Program | 4 Maloney 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1114548690 | Rebecca Blaguski | Registered Nurse | The Hospital of The University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1952944175 | Rebecca Miriam Barmherzig | Psychiatry & Neurology | 3501 Civic Centre Blvd, 10th Flr Ctrb, Neurology, Philadelphia, PA 19104 | 2019-10-21 |
| 1891257101 | James Paul Byrne | Surgery | Penn Presbyterian Medical Center, Division of Trauma, S, 51 N. 39th Street, Suite 120, 1st Floor Medical Office, Philadelphia, PA 19104 | 2019-04-04 |
| 1093276453 | Lauren Shreve | Student in an Organized Health Care Education/Training Program | Department of Surgery, Surgery Education - Penn Health, 3400 Spruce Street, 4 Maloney, Philadelphia, PA 19104 | 2019-03-28 |
| 1285194282 | Lauren M Christie | Student in an Organized Health Care Education/Training Program | Penn Presbyterian Medical Center, 51 N. 39th Street, Philadelphia, PA 19104 | 2019-03-25 |
| 1114487683 | Sabrina Layne | Student in an Organized Health Care Education/Training Program | 3400 Spruce Street, 100 Centrex, Philadelphia, PA 19104 | 2019-03-21 |
| 1811457310 | Kia Lor | Student in an Organized Health Care Education/Training Program | Hospital of University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104 | 2019-03-21 |
| Find all providers in zip 19104 | ||||
| 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 |
|---|---|---|---|---|
| 1457994923 | Chauncey Eyecare Associates Pllc | Optometrist | 6001 N 5th St Ofc, Philadelphia, PA 19120-1873 | 2019-10-28 |
| 1427604982 | Wendy Lin | Optometrist | 2828 Almond St, Philadelphia, PA 19134-4710 | 2019-08-12 |
| 1174182588 | Harbison Eye Care LLC | Optometrist | 5597 Tulip St Ste B8, Philadelphia, PA 19124-1562 | 2019-06-10 |
| 1346809738 | Steven Judson Moon | Optometrist | 1501 N Broad St Ste 7, Philadelphia, PA 19122-3319 | 2019-06-10 |
| 1639644172 | Om Optical | Optometrist | 1318 Walnut St, Philadelphia, PA 19107-5410 | 2018-10-11 |
| 1770063687 | Brian Johnson | Optometrist | 1200 W Godfrey Avenue, Philadelphia, PA 19141-3323 | 2018-08-20 |
| 1508365784 | C Vision Inc | Optometrist | 1230 Chestnut St, Philadelphia, PA 19107-4849 | 2018-02-02 |
| 1043737943 | Wills Eye Optical Two, LLC | Optometrist | 800 Arch St, Philadelphia, PA 19107-3188 | 2017-08-23 |
| 1255854295 | Jin Gao | Optometrist | 602 N 11th St, Philadelphia, PA 19123-3324 | 2017-07-21 |
| 1043765050 | Chauncey Brown Jr. | Optometrist | 6001 N 5th Street, Office, Philadelphia, PA 19120-1825 | 2016-08-19 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19104 |
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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.