KEYDRON DWANE DEROSA (NPI# 1366514309) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366514309 |
| Entity Type | Individual |
| Full Name | KEYDRON DWANE DEROSA |
| Credential | OD DOCTOR OF OPTOMET |
| Practice Address |
1275 North Hermitage Road Walmart Vision Center Hermitage PA 16148 |
| Mailing Address |
6599 West Middletown Road Canfield OH 44406-9417 |
| Practice Telephone | 7243465950 |
| Practice Fax Number | 7243426246 |
| Mailing Telephone | 3307028855 |
| Mailing Fax Number | 3307028855 |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152W00000X | Optometrist | 3165T405 | OH | Eye and Vision Services Providers |
| Y | 152W00000X | Optometrist | 4976P | PA | Eye and Vision Services Providers |
| Street Address |
1275 NORTH HERMITAGE ROAD WALMART VISION CENTER |
| City | HERMITAGE |
| State | PA |
| Zip Code | 16148 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518571165 | Cassandra L Holder | Physical Therapist | 1559 N. Hermitage Rd, Hermitage, PA 16148 | 2020-09-01 |
| 1750927190 | Hermitage Endoscopy Center Inc | Clinic/Center | 949 N Hermitage Road, Hermitage, PA 16148 | 2019-11-20 |
| 1336791318 | Catlyn Marie Joseph | Pharmacist | 1851 East State St, Rite Aid Store #10995, Hermitage, PA 16148 | 2019-07-10 |
| 1386203107 | Kaitlyn Mostard-smith | Physical Therapist | 1599 N. Hermitage Rd., Hermitage, PA 16148 | 2019-06-06 |
| 1770001513 | Lee Ann Hougelman | Licensed Practical Nurse | 5454 E. State St., Hermitage, PA 16148 | 2017-08-31 |
| 1194245001 | Samantha C Kilar | Audiologist | 1623 Dutch Lane, Hermitage, PA 16148 | 2017-06-21 |
| 1538419197 | Sharon Lynn Taylor | Physician Assistant | 480 N Kerrwood Dr Ste 103, Hermitage, PA 16148 | 2012-09-11 |
| 1912289638 | Amanda Jo Kline | Physical Therapy Assistant | 260 S Buhl Farm Drive, Whispering Oaks Suite 326, Hermitage, PA 16148 | 2011-09-20 |
| 1447548573 | Robert Joseph Jackson | Licensed Practical Nurse | 5454 East State St, Hermitage, PA 16148 | 2011-07-11 |
| 1386974673 | Susan Dawn Mehallick | Specialist/Technologist | 1005 Campus Circle, Hermitage, PA 16148 | 2010-01-08 |
| Find all providers in zip 16148 | ||||
| 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 |
|---|---|---|---|---|
| 1477922177 | Gillispie Eye Care Pllc | Optometrist | 4130 Andrew Jackson Pkwy, Hermitage, TN 37076-2203 | 2015-09-23 |
| 1346401007 | Alette Howard Davis | Optometrist | 4761 Andrew Jackson Pkwy Ste 108, Hermitage, TN 37076-1354 | 2008-06-24 |
| 1417087552 | Margaret Elizabeth Davis | Optometrist | 4424 Lebanon Pk, Hermitage, TN 37076 | 2007-03-07 |
| 1881747129 | James David Gillispie | Optometrist | 5528a Old Hickory Blvd, Hermitage, TN 37076-2576 | 2007-01-19 |
| 1265475156 | Phillip R Hammond | Optometrist | 232 Jackson Meadows Dr, Hermitage, TN 37076-1425 | 2006-06-14 |
| 1043296429 | Neil G. Callahan O.d., P.C. | Optometrist | 2926 E State St, Hermitage, PA 16148-2757 | 2005-12-19 |
| 1972586766 | Margaret M Mastrian | Optometrist | 490 N Kerrwood Dr, Suite 203, Hermitage, PA 16148-5202 | 2005-11-25 |
| 1831188309 | Alan J Frank | Optometrist | 1818 E State St, Hermitage, PA 16148-1852 | 2005-10-18 |
| 1932105996 | John Balko and Associates Inc | Optometrist | 102 North Keel Ridge Road, Hermitage, PA 16148-3440 | 2005-06-24 |
| 1255783049 | David Aaron Ankney | Optometrist | 2160 E State St, Hermitage, PA 16148-2728 | 2016-07-06 |
| Find all providers in HERMITAGE | ||||
Please comment or provide details below to improve the information on KEYDRON DWANE DEROSA.
| 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.