Sally M Fife, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1017DT Issued in KY

Practice address

300 9TH St
Henderson, KY 42420-2751

Phone

(270) 827-8681

Fax

(270) 826-7687

NPI assigned

Dec 8, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312848000000",
    "number": "1053470542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 9TH ST",
            "address_2": "P O BOX 595",
            "city": "HENDERSON",
            "state": "KY",
            "postal_code": "424202751",
            "telephone_number": "270-827-8681",
            "fax_number": "270-826-7687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 9TH ST",
            "city": "HENDERSON",
            "state": "KY",
            "postal_code": "424202751",
            "telephone_number": "270-827-8681",
            "fax_number": "270-826-7687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIFE",
        "first_name": "SALLY",
        "middle_name": "M",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2011-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1017DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100121660",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO",
            "identifier": "0675230001",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000190215",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah J Faxon, APRN
• James M Fellows, MD
• James Ferguson, D.C.
• Joshua Andrew Fife, DO
• Kelly Winston Fife, M.D.
• First Steps
• FKS PLLC
• Shanya Fleming
• Virginia Sue Floyd, RPH
• Jason K Fogg, D.O.

• Optometrist in Henderson, KY
• Providers in Henderson, KY by specialty
• Optometrist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.