Clarkson Optometry Midwest Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

CLARKSON OPTOMETRY MIDWEST INC.

Doing business as

20/20 EyeCare

Practice address

1709 N Dixie Ave Ste 101
Elizabethtown, KY 42701-9496

Phone

(636) 200-4393

Fax

(502) 736-4490

NPI assigned

Jun 3, 2006

Organization subpart

No

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

Authorized official

Name

James Wachter

Title

Cmo

Phone

(636) 200-4393

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• 20/20 EyeCare Doing business as

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559865600000",
    "number": "1083652978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 207170",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753207156",
            "telephone_number": "636-200-4393",
            "fax_number": "636-527-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1709 N DIXIE AVE STE 101",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427019496",
            "telephone_number": "636-200-4393",
            "fax_number": "502-736-4490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARKSON OPTOMETRY MIDWEST INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2019-06-07",
        "status": "A",
        "authorized_official_last_name": "WACHTER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "636-200-4393"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77903961",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "20/20 EyeCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessica Ann Clark-Allen
• Brandi J Clark
• Matthew Brian Clark, APRN, FNP-C
• Samantha Rae Clark
• Valisa Ann Clark, APRN
• Sunday Sue Clauson, M.A.S.E.
• Kelly Lynn Claycamp, LPCA
• Jamie Claycomb
• Kyla Dawn Claycomb
• Greg Claywell, HEARING INSTRUMENT S

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2019; 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.