John Michael Soderling, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1281DT Issued in KY

Practice address

136 E Main Cross St
Greenville, KY 42345-1576

Phone

(270) 338-9636

Fax

(270) 338-9639

NPI assigned

Nov 4, 2005

Last updated

Nov 21, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 8

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

Specialty

Optometry

Education

Southern College of Optometry, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Soderling Eye Care, PSC

  • Optometrist
  • Greenville, KY
  • NPI 1063798957
  Medicare reassignment NPD Authorized official
• Oak Tree Eye Clinic Inc PSC

  • Optometrist
  • Central City, KY
  • NPI 1821089640
  NPD (past)

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321833600000",
    "number": "1225029556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 E MAIN CROSS ST",
            "city": "GREENVILLE",
            "state": "KY",
            "postal_code": "423451576",
            "telephone_number": "270-338-9636",
            "fax_number": "270-338-9639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 E MAIN CROSS ST",
            "city": "GREENVILLE",
            "state": "KY",
            "postal_code": "423451576",
            "telephone_number": "270-338-9636",
            "fax_number": "270-338-9639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SODERLING",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2011-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1281DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "KY1281",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NVA",
            "identifier": "180034",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77012813",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GE",
            "identifier": "25125",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP",
            "identifier": "DB4678",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTICHOICE",
            "identifier": "297436",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVESIS",
            "identifier": "21435",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00107376",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Lee Smith, PH.D.
• Snyder Chiropractic Center, PSC
• Howard Lee Snyder, D.C.
• Kimberly Beth Snyder
• Soderling Eye Care, PSC
• Lee Bradford Sparks, MD
• Patience Ranae Spence, APRN-CNP
• Alicia Stewart
• Laura H. Stiles, PHARMD
• Allyson Lee Stovall, RN, MSN, PMHNP-BC

• Optometrist in Greenville, KY
• Providers in Greenville, KY by specialty
• Optometrist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.