Active NPI
Central Kentucky Eyecare and Wellness, LLC
- Optometrist
- Lexington, KY
National Provider Identifier
1104587591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- Legal business name
- CENTRAL KENTUCKY EYECARE AND WELLNESS, LLC
- Practice address
- 3221 Summit Square PL Ste 200
Lexington, KY 40509-2655 - Phone
- (859) 303-6464
- Fax
- (859) 303-6465
- NPI assigned
- Jan 6, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Velva Hughes
- Title
- Practice Administrator
- Phone
- (859) 447-0895
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | Primary |
Addresses
Primary practice location
3221 Summit Square PL Ste 200
Lexington, KY 40509-2655
Mailing address
3221 Summit Square PL Ste 200
Lexington, KY 40509-2655
Phone (859) 303-6464
Other names 1
- Central Kentucky Eyecare
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220426001173 | KY | Part B Supplier - Clinic/Group Practice | 4688061476 |
Receives reassigned benefits from 3 practitioners Practice locations: Lexington, KY |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 18D2257721 | Central Kentucky Eyecare and Wellness LLC | Certificate of waiver | Apr 8, 2028 |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1641427200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1641513600000",
"number": "1104587591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3221 SUMMIT SQUARE PL STE 200",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405092655",
"telephone_number": "859-303-6464",
"fax_number": "859-303-6465"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3221 SUMMIT SQUARE PL STE 200",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405092655",
"telephone_number": "859-303-6464",
"fax_number": "859-303-6465"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CENTRAL KENTUCKY EYECARE AND WELLNESS, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-01-06",
"last_updated": "2022-01-07",
"certification_date": "2022-01-07",
"status": "A",
"authorized_official_last_name": "HUGHES",
"authorized_official_first_name": "VELVA",
"authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
"authorized_official_telephone_number": "859-447-0895"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Central Kentucky Eyecare",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Central Kentucky Eyecare",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Lexington, KY
- Central Kentucky Anesthesia PSC
- Central Kentucky Case Management, Inc.
- Central Kentucky Chiropractic, PLLC
- Central Kentucky Ear, Nose & Throat, P.S.C.
- Central Kentucky Endodontics PLLC
- Central Kentucky Foot & Ankle PSC
- Central Kentucky Gastroenterology
- Central Kentucky High Risk Obstetrics, PLLC
- Central Kentucky Medical Group PSC
- Central Kentucky Mobility
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2022; 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.