Professional Opticians PSC

Primary specialty

OpticianTaxonomy code 156FX1800X

License

0366 Issued in KY

Legal business name

PROFESSIONAL OPTICIANS PSC

Practice address

165 Moore Dr
Lexington, KY 40503

Phone

(859) 278-5409

Fax

(859) 276-3491

NPI assigned

Aug 29, 2006

Organization subpart

No

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

Authorized official

Name

Mr. John C Holtmann, ABO

Title

President

Phone

(859) 278-5409

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194834713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 MOORE DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "40503",
            "telephone_number": "859-278-5409",
            "fax_number": "859-276-3491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 MOORE DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "40503",
            "telephone_number": "859-278-5409",
            "fax_number": "859-276-3491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL OPTICIANS PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOLTMANN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "859-278-5409",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ABO"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "KY",
            "license": "0366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000066363",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVESIS",
            "identifier": "14560",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "52903663",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Myrtle W Procter, LCSW
• Gage Proctor
• Glenna Laura Proctor, RN
• Monet Proctor
• Professional Home Health Care Agency, Inc.
• Professional Pharmacy
• Professional Speech Solutions, LLC
• Shane Profio, DO
• Erna S Profitt, LSW
• Joshua Seth Profitt, PHARMD

• Optician in Lexington, KY
• Providers in Lexington, KY by specialty
• Optician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.