NPIMap

Organization Active NPI

Myeyedr Optometry of Kentucky, PLLC

  • Optometrist
  • Cynthiana, KY
National Provider Identifier
1154090769
Registry record updated May 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MYEYEDR OPTOMETRY OF KENTUCKY, PLLC
Practice address
308 N Main St
Cynthiana, KY 41031-1210
Phone
(859) 234-1424
Fax
(859) 234-5463
NPI assigned
Sep 8, 2021
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Sue Downes
Title
Secretary
Phone
(703) 847-8899

Other NPIs on the same Medicare enrollment 8

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

Other NPIs with the same Medicare PAC ID 1

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

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 19

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D2302452Myeyedr Optometry of Kentucky, PLLC308 N Main Street, Cynthiana, KY 41031Certificate of waiverApr 9, 2028

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Myeyedr Optometry of Kentucky PLLC308 N Main St, Cynthiana, KY 41031-1210(859) 234-1424 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jul 30, 2019

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20190814002176 KY Part B Supplier - Clinic/Group Practice 1951638964 Receives reassigned benefits from 23 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Newport, KY; Louisville, KY; Lexington, KY; Cynthiana, KY; Crescent Springs, KY; Cold Spring, KY; Florence, KY
O20221102000868 KY DME Supplier - Physician - Optometrist 1951638964 Practice locations: Cynthiana, KY

National Provider Directory

National Provider Directory
Tax ID family
Myeyedr Optometry of Kentucky PLLC10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

1400 Gloria Terrell Dr
Ste H
Wilder, KY 41076
Phone (859) 441-3400

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

308 N Main St
Cynthiana, KY 41031-1210

Mailing address

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

Other names 1

NPPES NPI Registry
  • MyEyeDr. Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 23, 2022.

{
    "created_epoch": "1631059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653264000000",
    "number": "1154090769",
    "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",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 N MAIN ST",
            "city": "CYNTHIANA",
            "state": "KY",
            "postal_code": "410311210",
            "telephone_number": "859-234-1424",
            "fax_number": "859-234-5463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYEYEDR OPTOMETRY OF KENTUCKY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-08",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-23",
        "status": "A",
        "authorized_official_last_name": "DOWNES",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "703-847-8899"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MyEyeDr.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MyEyeDr.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cynthiana, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 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.

Verify at the official NPI Registry.