Organization Active NPI

Dana S Chitwood LLC

  • Clinic/Center
  • Corbin, KY
National Provider Identifier
1083889497
Registry record updated May 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
1700DT Issued in KY
Legal business name
DANA S CHITWOOD LLC
Practice address
60 S Stewart Rd
Corbin, KY 40701-4675
Phone
(606) 258-8888
Fax
(606) 523-5596
NPI assigned
Apr 25, 2008
Last updated
May 28, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2008

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

Authorized official

Name
Dr. Dana S. Chitwood, ODNPI 1861690992
Title
Optometrist
Phone
(606) 258-8888

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
Clinic/Center 261Q00000X 1700DT KY Primary

Addresses

Primary practice location

60 S Stewart Rd
Corbin, KY 40701-4675

Mailing address

60 S Stewart Rd
Corbin, KY 40701-4675
Phone (606) 258-8888

Other identifiers 1

IdentifierTypeStateIssuer
7100025430MedicaidKY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080529000232 KY Part B Supplier - Clinic/Group Practice 3476623760 Receives reassigned benefits from 1 practitioner
Practice locations: Corbin, KY

National Provider Directory

National Provider Directory

Locations

60 S Stewart Rd
Ste 5
Corbin, KY 40701
Phone (606) 258-8888

Practitioners & affiliated clinicians

Practitioners 1

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": "1209081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211932800000",
    "number": "1083889497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 S STEWART RD",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407014675",
            "telephone_number": "606-258-8888",
            "fax_number": "606-523-5596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 S STEWART RD",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407014675",
            "telephone_number": "606-258-8888",
            "fax_number": "606-523-5596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANA S CHITWOOD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-25",
        "last_updated": "2008-05-28",
        "status": "A",
        "authorized_official_last_name": "CHITWOOD",
        "authorized_official_first_name": "DANA",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "606-258-8888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "KY",
            "license": "1700DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100025430",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corbin, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.