MEDICARE: DR. KERI JO VERVAET O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	2435	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447230628
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KERI JO VERVAET O.D.

Provider Business Mailing Address
First Line	:	3365 CHANDON WAY
Second Line	:
City	:	HIGHLANDS RANCH
State	:	CO
Zip	:	80126-8049
Country	:	US
Telephone Number	:	303-681-1133
Fax Number	:

Provider Business Practice Location Address
First Line	:	9330 S UNIVERSITY BLVD
Second Line	:	SUITE 220
City	:	HIGHLANDS RANCH
State	:	CO
Zip	:	80126-5065
Country	:	US
Telephone Number	:	303-346-8400
Fax Number	:	303-346-1785

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2006
Last Update Date	:	02/19/2021

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