Organization Active NPI

Tri-State Centers for Sight Inc

Doing business as Kentucky Eye Institute

  • Ophthalmology Physician
  • London, KY
National Provider Identifier
1124831672
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
TRI-STATE CENTERS FOR SIGHT INC
Doing business as
Kentucky Eye Institute
Practice address
130 Thompson Poynter Rd Ste 1
London, KY 40741-7280
Phone
(606) 878-2012
Fax
(606) 862-9487
NPI assigned
Jan 29, 2025
Last updated
May 8, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2025

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

Authorized official

Name
Candice B Davis
Title
Chief Revenue Cycle Officer
Phone
(916) 990-7590

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

130 Thompson Poynter Rd Ste 1
London, KY 40741-7280

Mailing address

500 Ross St 154-0455 Box 360485
Pittsburgh, PA 15262-0001

Other names 1

  • Kentucky Eye Institute Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040219000102 KY Part B Supplier - Clinic/Group Practice 7113812090 Receives reassigned benefits from 31 practitioners
17 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mount Sterling, KY; Versailles, KY; Paintsville, KY; Morehead, KY; Middlesboro, KY; Maysville, KY; Lexington, KY; London, KY…

Other NPIs on the same Medicare enrollment 17

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

View all 17

National Provider Directory

National Provider Directory
Tax ID family
Tri-State Centers for Sight Inc27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

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

View all 26

Practitioners & affiliated clinicians

Practitioners 3

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": "1738108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746662400000",
    "number": "1124831672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 ROSS ST 154-0455 BOX 360485",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152620001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 THOMPSON POYNTER RD STE 1",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407417280",
            "telephone_number": "606-878-2012",
            "fax_number": "606-862-9487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-STATE CENTERS FOR SIGHT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-29",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "CANDICE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CHIEF REVENUE CYCLE OFFICER",
        "authorized_official_telephone_number": "916-990-7590"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kentucky Eye Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in London, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2025; 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.