NPIMap

Organization Active NPI

Eye Associates of Southern Indiana PC

  • Eyewear Supplier
  • Frankfort, KY
National Provider Identifier
1073533865
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
EYE ASSOCIATES OF SOUTHERN INDIANA PC
Practice address
102 Diagnostic Dr
Frankfort, KY 40601-6524
Phone
(502) 223-8258
Fax
(502) 875-9481
NPI assigned
Jul 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Authorized official

Name
Kristopher Pugh, MD
Title
Owner/MD
Phone
(812) 284-0660

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

102 Diagnostic Dr
Frankfort, KY 40601-6524

Mailing address

302 W 14TH St Ste 100a
Jeffersonville, IN 47130-3751
Phone (812) 280-2162

Other names 1

  • Eye Care For Kentucky Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180913001940 KY DME Supplier - Physician - Ophthalmology 4183688310 Practice locations: Frankfort, KY

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D2209911Eye Associates of Southern Indiana PC102 Diagnostic Dr, Frankfort, KY 40601Certificate of waiverJan 18, 2027

National Provider Directory

National Provider Directory
Tax ID family
Eye Associates of S in PC10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1073533865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 W 14TH ST STE 100A",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471303751",
            "telephone_number": "812-280-2162",
            "fax_number": "812-284-3822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 DIAGNOSTIC DR",
            "city": "FRANKFORT",
            "state": "KY",
            "postal_code": "406016524",
            "telephone_number": "502-223-8258",
            "fax_number": "502-875-9481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE ASSOCIATES OF SOUTHERN INDIANA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "PUGH",
        "authorized_official_first_name": "KRISTOPHER",
        "authorized_official_title_or_position": "OWNER/MD",
        "authorized_official_telephone_number": "812-284-0660",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eye Care For Kentucky",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Eye Care For Kentucky",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Frankfort, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.