EDWARD M KENSHOCK (NPI# 1417980913) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417980913 |
| Entity Type | Individual |
| Full Name | EDWARD M KENSHOCK |
| Credential | OD |
| Practice Address |
1629 Owen Dr Fayetteville NC 28304-3456 |
| Mailing Address |
1726 Metromedical Dr Fayetteville NC 28304-3861 |
| Practice Telephone | 9104842284 |
| Practice Fax Number | 9104841673 |
| Mailing Telephone | 9104842284 |
| Mailing Fax Number | 9104841673 |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2011-05-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 1799 | NC | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 89093JU | 05 | |
| DEA | MK0611194 | 01 |
| Street Address |
1629 OWEN DR |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28304-3456 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639136229 | Shelby A Stephenson | Ophthalmology | 1629 Owen Dr, Fayetteville, NC 28304-3425 | 2006-04-27 |
| 1487092490 | Leah Ashley Bonaparte | Internal Medicine | 1629 Owen Dr, Fayetteville, NC 28304-3425 | 2013-06-12 |
| 1588781108 | Cape Fear Eye Associates | Technician/Technologist | 1629 Owen Dr, Fayetteville, NC 28304-3456 | 2007-03-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598301061 | Coast To Coast Bilingual Counseling | Social Worker | 910 Hope Mills Road, Fayetteville, NC 28304 | 2019-11-20 |
| 1811530561 | Frances L. Hurst | Technician | 6732 Carloway Dr, Fayetteville, NC 28304 | 2019-10-25 |
| 1538717764 | Rose Mary A O'conner | Technician | 3530 Madison Ave, Fayetteville, NC 28304 | 2019-08-30 |
| 1932756087 | Sally Frances Jones | Technician | 2053 Mango Circle, Fayetteville, NC 28304 | 2019-08-23 |
| 1326528803 | Jeneen Yvette Townsend | Counselor | 2671 Adams Lake Dr Apt F, Fayetteville, NC 28304 | 2018-08-15 |
| 1780179580 | Ma Cornelia Villavicencio Leano | Nurse Practitioner | 3081 Stone Carriage Cir Apt Z, Fayetteville, NC 28304 | 2018-06-25 |
| 1861986267 | Pediatric After Hours Care of Fayetteville | Pediatrics | 556 Sandhurst Drive, Fayetteville, NC 28304 | 2018-06-19 |
| 1700386133 | Good Night Medical of Ohio, LLC | Durable Medical Equipment & Medical Supplies | 405 Owen Dr Ste 202, Fayetteville, NC 28304 | 2018-02-12 |
| 1003321365 | Valleygate Dental Surgery Center of Fayetteville, LLC | Dentist | 2038 Litho Place, Fayetteville, NC 28304 | 2017-12-08 |
| 1871004663 | The Salt Project | Marriage & Family Therapist | 1611-b Owen Dr., Fayetteville, NC 28304 | 2017-10-19 |
| Find all providers in zip 28304 | ||||
| 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 |
|---|---|---|---|---|
| 1679103220 | Atl Optical LLC | Optometrist | 1135 Highway 85 N Ste D, Fayetteville, GA 30214-2085 | 2020-01-23 |
| 1306406269 | Idell Marie Mitchell | Optometrist | Eye Clinic, 1100 N College Ave, Fayetteville, AR 72703 | 2019-06-13 |
| 1922515808 | Focused Family Eye Care, Pllc | Optometrist | 3730 N Vantage Dr, Fayetteville, AR 72703-5442 | 2018-01-02 |
| 1952829186 | Davis Eye Associates Inc. | Optometrist | 2901 E Zion Rd Ste 13, Fayetteville, AR 72703-5070 | 2017-09-08 |
| 1427405133 | National Eye Care, Inc | Optometrist | 5160 Kinloch Circle, Fayetteville, NY 13066 | 2016-05-23 |
| 1356730493 | Myeyedr Optometry of North Carolina, Pllc | Optometrist | 326 Glensford Dr, Suite 108, Fayetteville, NC 28314 | 2015-01-13 |
| 1013314608 | Ashley Ballard | Optometrist | 326 Glensford Dr Ste 108, Fayetteville, NC 28314-3219 | 2014-11-25 |
| 1891108924 | Focus Vision Optometric Care, Pllc | Optometrist | 1594 Skibo Rd, Fayetteville, NC 28303-3478 | 2014-06-06 |
| 1336488204 | Northwest Vision Group | Optometrist | 3215 E Summershade Dr, Fayetteville, AR 72703-4375 | 2013-02-12 |
| 1912257247 | Zachary Robert Engle | Optometrist | 419 Cross Creek Mall, Ste 302, Fayetteville, NC 28303-7285 | 2012-09-13 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 28304 |
Please comment or provide details below to improve the information on EDWARD M KENSHOCK.
| 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.