Individual provider Active NPI

William H. Vickers, O. D.

  • Optometrist
  • Barbourville, KY
National Provider Identifier
1083766638
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
KY1002DT Issued in KY
Practice address
215 North Allison
Barbourville, KY 40906
Phone
(606) 546-4166
Fax
(606) 546-4167
NPI assigned
Jan 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X KY1002DT KY Primary

Addresses

Primary practice location

215 North Allison
Barbourville, KY 40906

Mailing address

P. O. Box 400
Barbourville, KY 40906-1336
Phone (606) 546-4166

Other identifiers 1

IdentifierTypeStateIssuer
77010023MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120302000526 KY Practitioner - Optometry 7517126097

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Barbourville Family Health CenterGroup PAC ID 7416867387, shared by 3 NPIs, 30 clinicians

Practice addresses (Care Compare)

215 N Allison Ave
Barbourville, KY 40906-1336
Phone (606) 546-9287

315 Hospital Dr
Suite 2
Barbourville, KY 40906-7917
Phone (606) 546-4060

PO Box
Suite 1150
Barbourville, KY 40906-1336

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
KY1002DTKYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Barbourville Family Health Center Past Accepting new patients
Barbourville Family Health Center Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083766638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P. O. BOX 400",
            "city": "BARBOURVILLE",
            "state": "KY",
            "postal_code": "409061336",
            "telephone_number": "606-546-4166",
            "fax_number": "606-546-4167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 NORTH ALLISON",
            "city": "BARBOURVILLE",
            "state": "KY",
            "postal_code": "40906",
            "telephone_number": "606-546-4166",
            "fax_number": "606-546-4167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICKERS",
        "first_name": "WILLIAM",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "O. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "KY1002DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77010023",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Barbourville, KY

Sources for this page

Verify at the official NPI Registry.