Individual provider Active NPI

Elizabeth Courson Tanner, OD

  • Optometrist
  • Lexington, KY
National Provider Identifier
1144622390
Registry record updated Feb 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2058DT Issued in KY
Practice address
3221 Summit Square PL Ste 200
Lexington, KY 40509-2655
Phone
(859) 303-6464
NPI assigned
Sep 18, 2014
Last updated
Feb 11, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2058DT KY Primary

Addresses

Primary practice location

3221 Summit Square PL Ste 200
Lexington, KY 40509-2655

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

Other practice location 1

289 Ireland Ave
IRACH Optometry clinic
Fort Knox, KY 40121-5111
Phone (502) 624-9663

Other names 1

  • Elizabeth Ann Courson Other name

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
I20180208003056 KY Practitioner - Optometry 2264758747 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Kentucky Eyecare and Wellness, LLCGroup PAC ID 4688061476, 3 clinicians

Practice addresses (Care Compare)

142 Pavilion Pkwy
Newport, KY 41071-2884
Phone (859) 291-9464

3221 Summit Square PL
Suite 200
Lexington, KY 40509-2655
Phone (859) 303-6464

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2058DTKYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Kentucky Eyecare and Wellness, LLC Optometrist CurrentSince Jan 15, 2022 Accepting new patients
Myeyedr Optometry of Kentucky, PLLC Optometrist CurrentSince Feb 23, 2026 Accepting new patients
Myeyedr Optometry of Indiana, LLC Optometrist Past Accepting new patients

Locations

3221 Summit Square Pl
Ste 200
Lexington, KY 40509
Phone (859) 303-6464

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1410998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770768000000",
    "number": "1144622390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "289 Ireland Ave",
            "address_2": "IRACH Optometry clinic",
            "address_purpose": "LOCATION",
            "city": "Fort Knox",
            "state": "KY",
            "postal_code": "401215111",
            "country_code": "US",
            "telephone_number": "502-624-9663",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANNER",
        "first_name": "ELIZABETH",
        "middle_name": "COURSON",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-18",
        "last_updated": "2026-02-11",
        "certification_date": "2026-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "2058DT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "COURSON",
            "middle_name": "ANN",
            "credential": "OD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.