Organization Active NPI

Downey Eye Clinic, PLLC

  • Optometrist
  • Russell Springs, KY
National Provider Identifier
1083406490
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
DOWNEY EYE CLINIC, PLLC
Practice address
310 Steve Dr Ste 1
Russell Springs, KY 42642-4599
Phone
(270) 866-4414
NPI assigned
May 21, 2025
Last updated
May 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2025

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

Authorized official

Name
Jacob Burton, O.D.NPI 1629324918
Title
Owner / Optometrist
Phone
(270) 384-6043

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

310 Steve Dr Ste 1
Russell Springs, KY 42642-4599

Mailing address

1463 Campbellsville Rd
Columbia, KY 42728-2263
Phone (270) 384-6043

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250717003735 KY DME Supplier - Physician - Optometrist 9830561117 Practice locations: Russell Springs, KY

Other NPIs with the same Medicare PAC ID 1

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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Downey Eye Clinic, PLLC310 Steve Dr, Russell Springs, KY 42642-4599(270) 866-4414 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Jul 13, 2023

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

310 Steve Dr
Ste 1
Russell Springs, KY 42642
Phone (270) 866-4414

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1747785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747785600000",
    "number": "1083406490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1463 CAMPBELLSVILLE RD",
            "city": "COLUMBIA",
            "state": "KY",
            "postal_code": "427282263",
            "telephone_number": "270-384-6043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 STEVE DR STE 1",
            "city": "RUSSELL SPRINGS",
            "state": "KY",
            "postal_code": "426424599",
            "telephone_number": "270-866-4414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOWNEY EYE CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-21",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A",
        "authorized_official_last_name": "BURTON",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "OWNER / OPTOMETRIST",
        "authorized_official_telephone_number": "270-384-6043",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Russell Springs, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2025; 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.