Central Kentucky Optometric Associates PSC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

CENTRAL KENTUCKY OPTOMETRIC ASSOCIATES PSC

Practice address

108 Commercial Ave
Springfield, KY 40069-1413

Phone

(859) 336-9388

Fax

(859) 336-9970

NPI assigned

Jun 1, 2006

Last updated

Nov 19, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Patricia M Hollingsworth-Cecconi, OD

Title

Sec/Treas

Phone

(859) 336-9388

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Central Kentucky Optometric Associates PSC

  • Optometrist
  • Lebanon, KY
  • NPI 1902843378

  9335172949

  Same PAC ID

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Central Kentucky Optometric Associates PSC

  dba Uptown EyeCare

  • Optometrist
  • Shepherdsville, KY
  • NPI 1558558361

  O20050914000929

  Same enrollment
• Central Kentucky Optometric Associates PSC

  • Optometrist
  • Lebanon, KY
  • NPI 1902843378

  O20050914000929

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare medical equipment & supply locations

Tax ID family

Central Kentucky Optometric Associates PSC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Central Kentucky Optometric Associates PSC

  • Optometrist
  • Lebanon, KY
  • NPI 1902843378
  NPD tax ID

Locations

Practitioners 2

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.

• John W Cecconi Jr., O.D.

  • Optometrist
  • Springfield, KY
  • NPI 1487624029
  NPD (past)
• Paul G Taylor, O.D.

  • Optometrist
  • Lebanon, KY
  • NPI 1174593701
  NPD (past)

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227052800000",
    "number": "1114964681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 169",
            "city": "SPRINGFIELD",
            "state": "KY",
            "postal_code": "400690169",
            "telephone_number": "859-336-9388",
            "fax_number": "859-336-9970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 COMMERCIAL AVE",
            "city": "SPRINGFIELD",
            "state": "KY",
            "postal_code": "400691413",
            "telephone_number": "859-336-9388",
            "fax_number": "859-336-9970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL KENTUCKY OPTOMETRIC ASSOCIATES PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2008-11-19",
        "status": "A",
        "authorized_official_last_name": "HOLLINGSWORTH-CECCONI",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SEC/TREAS",
        "authorized_official_telephone_number": "859-336-9388",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77903383",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Holly Marie Cambron, M.S., CCC-SLP
• Laura S Cayce, PHARMD
• John W Cecconi Jr., O.D.
• Courtney Danielle Cecil
• Jenna Marie Cecil, MS, RDN, LD
• Central Kentucky Physical Therapy LLC
• Central Pharmacy
• Lisa Chesser, LMT
• Clay Thomas Cinnamon, PT
• Claywell, Inc (Medica Pharmacy)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2008; 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.