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12100 Kennedy Ln, Suite 206, Fredericksburg, VA 22407-6760 | |
| (540) 785-3937 | |
| (540) 785-5498 |
| Full Name | |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 12100 Kennedy Ln, Fredericksburg, Virginia |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669482600 | NPI | - | NPPES |
| 170333 | Other | VA | AVESIS PROVIDER |
| 410048278 | Other | VA | MEDICARE RAILROAD |
| 5161390001 | Other | VA | DMES/ MEDICARE SUPPLIES |
| 902137 | Other | VA | BLOCK PROVIDER |
| 4091903 | Other | VA | AETNA PROVIDER |
| 452927 | Other | VA | ANTHEM BC/BS PROVIDER |
| 32467 | Other | VA | MAMSI /UNITED HEALTHCARE |
| 09235591 | Medicaid | VA | |
| 2150133 | Other | VA | FIRST HEALTH/MAILHANDLERS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 0618000074 (Virginia) | Primary |
| Provider Name | William R Kossol |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1649266248 PECOS PAC ID: 9931159837 Enrollment ID: I20051110000948 |
| Provider Name | Sarah P Brannon |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1023098688 PECOS PAC ID: 4183635774 Enrollment ID: I20060510000513 |
| Provider Name | Sonia Joshi Rose |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1245261692 PECOS PAC ID: 7012914849 Enrollment ID: I20061108000479 |
| Mailing Address | Practice Location Address |
|---|---|
12100 Kennedy Ln, Suite 206, Fredericksburg, VA 22407-6760 Ph: (540) 785-3937 | 12100 Kennedy Ln, Suite 206, Fredericksburg, VA 22407-6760 Ph: (540) 785-3937 |
Dr. Carissa Lee Novotny, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 625 Warrenton Rd Ste 105, Fredericksburg, VA 22406 Phone: 540-374-1445 | |
National Vision Inc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 9829 Patriot Hwy, Fredericksburg, VA 22407 Phone: 540-376-6888 | |
Dr. Sarah Pilat Brannon, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 12100 Kennedy Ln, Ste 206, Fredericksburg, VA 22407 Phone: 540-785-3937 Fax: 540-785-5498 | |
Samuel C Smart, DOCTOR OF OPTOMETRY Optometrist Medicare: Medicare Enrolled Practice Location: 230 Butler Road, Fredericksburg, VA 22405 Phone: 540-373-3021 Fax: 540-373-5565 | |
Eye Doctor Office, Inc. Optometrist Medicare: Medicare Enrolled Practice Location: 3102 Plank Rd Ste 395, Fredericksburg, VA 22407 Phone: 540-786-2020 | |
Steffani A. Deas, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 110 Cambridge Street, Access Eye Centers, Fredericksburg, VA 22405 Phone: 540-371-2020 Fax: 540-373-0141 | |
Dr. Cambrie Shae Chandler, O.D. Optometrist Medicare: Medicare Enrolled Practice Location: 12 Chatham Heights Rd Ste 100, Fredericksburg, VA 22405 Phone: 800-572-2722 |