Active NPI
Kevin Martin Adams, OD
- Optometrist
- Murray, KY
National Provider Identifier
1184782609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1157DT
- Practice address
- 308 So 12TH St
Murray, KY 42071 - Phone
- (270) 759-2500
- Fax
- (270) 759-8515
- NPI assigned
- Dec 5, 2006
- Last updated
- Mar 9, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1157DT | KY | Primary |
Addresses
Primary practice location
308 So 12TH St
Murray, KY 42071
Mailing address
308 So 12TH St
Murray, KY 42071
Phone (270) 759-2500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 77011575 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1157DT | KY | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maple Street Counseling Center PLLC | Past | Accepting new patients | |
| Maple Street Counseling Center PLLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Cognitive Connect Counseling
- Professional Counselor
- Murray, KY
- NPI 1255075131
-
dba Cognitive Connect Counseling
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Cottage Grove, TN
- NPI 1598354813
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1268092800000",
"number": "1184782609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "308 SO 12TH ST",
"city": "MURRAY",
"state": "KY",
"postal_code": "42071",
"telephone_number": "270-759-2500",
"fax_number": "270-759-8515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "308 SO 12TH ST",
"city": "MURRAY",
"state": "KY",
"postal_code": "42071",
"telephone_number": "270-759-2500",
"fax_number": "270-759-8515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADAMS",
"first_name": "KEVIN",
"middle_name": "MARTIN",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-05",
"last_updated": "2010-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "KY",
"license": "1157DT",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "77011575",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Murray, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.