Leroy Taylor Kincannon III, O.D.
NPI 1528173846ActiveIndividual· Optometrist· Grand Rapids, MN
Optometrist (O.D.) in Grand Rapids, Minnesota, licensed in MN, with an NPI issued in August 2006. Enrolled in Medicare as practitioner - optometry.
Overview
| NPI | 1528173846 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | O.D. |
| Sole proprietor | No |
| NPI issued | Aug 19, 2006 |
| Last updated in NPPES | Jul 8, 2007 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Optometrist Primary | 152W00000X | 2466 | MN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Optometry (MN) |
|---|
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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