John Harold Matthews, O.D. – Optometrist

Key facts

NPI: 1235153404
Entity type: Individual (NPI type 1)
Primary specialty: Optometrist 152W00000X
License: 1518DT (KY)
Practice address: 725 Campbellsville Byp
Campbellsville, KY 42718-8846
Phone: (270) 274-4144
Fax: (270) 274-2176
NPI assigned: Jul 27, 2006
Sex: Male
Sole proprietor: Yes

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 and National Provider Directory roles.

20-20 Eyecare PSC Optometrist · Louisville, KY · NPI 1710924949

NPD (past) OPTOMETRIST
Clarkson Optometry Midwest Inc Optometrist · Lebanon, KY · NPI 1366520702

NPD (past) OPTOMETRIST

Medicare Care Compare profile

Specialty: Optometry
Education: New England College of Optometry, 2001
Medicare assignment: Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

725 Campbellsville Byp
Campbellsville, KY 42718-8846
Phone (270) 465-3669

Procedures performed for Medicare patients

Procedure	Number of procedures
Cataract surgery	17

Medicare participation

Medicare fee-for-service enrollment: Enrolled in KY
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20040330000793	KY	Practitioner - Optometry	3476545716	Practice locations: Campbellsville, KY

National Provider Directory

Medicare enrollment (NPD): Yes

Practice roles

Organization	Specialty	Status	New patients
Clarkson Optometry Midwest Inc	Optometrist	Past	Accepting new patients
20-20 Eyecare PSC	Optometrist	Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Optometrist	152W00000X	1518DT	KY	Yes

Addresses

Primary practice location

725 Campbellsville Byp
Campbellsville, KY 42718-8846

Mailing address

725 Campbellsville Byp
Campbellsville, KY 42718-8846
Phone (270) 465-3669

Other identifiers

Identifier	Type	State	Issuer
001511979	Other	KY	HIGHMARK
22555	Other	KY	SPECTERA
000000340031	Other	KY	ANTHEM
140639321615	Other	KY	HUMANA
77000594	Medicaid	KY

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 16, 2018.

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1235153404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 CAMPBELLSVILLE BYP",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427188846",
            "telephone_number": "270-465-3669",
            "fax_number": "270-789-0643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 CAMPBELLSVILLE BYP",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427188846",
            "telephone_number": "270-274-4144",
            "fax_number": "270-274-2176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTHEWS",
        "first_name": "JOHN",
        "middle_name": "HAROLD",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1518DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "001511979",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "22555",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000340031",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "140639321615",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77000594",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Campbellsville, KY

All providers in Campbellsville, KY · Optometrist in Kentucky

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 16, 2018. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
Medicare Care Compare provider data (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.