Individual provider Active NPI

Denise Marie Dobbins Kowalik, OD

  • Optometrist
  • Danville, KY
National Provider Identifier
1235276163
Registry record updated Jun 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1170DT Issued in KY
Practice address
1541 Lebanon Rd Ste 2
Danville, KY 40422-8349
Phone
(859) 239-4500
NPI assigned
Jan 31, 2007
Last updated
Jun 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1170DT KY Primary

Addresses

Primary practice location

1541 Lebanon Rd Ste 2
Danville, KY 40422-8349

Mailing address

PO Box 990
Danville, KY 40423-0990
Phone (859) 239-2360

Other practice location 1

100 Walton Ave
Danville, KY 40422-8414
Phone (859) 236-8093

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100817000441 KY Practitioner - Optometry 7416081179 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.36 of 100Reported as group
Quality
64.78
Promoting interoperability
100
Improvement activities
40
Cost
67.25

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1170DTKYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ephraim McDowell Health Resource, Inc CurrentSince Feb 26, 2020 Accepting new patients
Ephraim McDowell Health Resource, Inc. Optometrist CurrentSince Feb 26, 2020 Accepting new patients
Ephraim McDowell Health Resource, Inc. Current Accepting new patients
Ephraim McDowell Health Resource, Inc. Past Accepting new patients

Locations

109 Daniel Dr
Danville, KY 40422
Phone (859) 236-3361

1541 Lebanon Rd
Ste 2
Danville, KY 40422
Phone (859) 239-4500

216 W Walnut St
Ste B
Danville, KY 40422
Phone (859) 239-4840

217 S 3rd St
Danville, KY 40422
Phone (859) 239-1000

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1235276163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 990",
            "city": "DANVILLE",
            "state": "KY",
            "postal_code": "404230990",
            "telephone_number": "859-239-2360",
            "fax_number": "859-239-6785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 LEBANON RD STE 2",
            "city": "DANVILLE",
            "state": "KY",
            "postal_code": "404228349",
            "telephone_number": "859-239-4500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Walton Ave",
            "address_purpose": "LOCATION",
            "city": "Danville",
            "state": "KY",
            "postal_code": "404228414",
            "country_code": "US",
            "telephone_number": "859-236-8093",
            "fax_number": "859-236-8893",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOBBINS KOWALIK",
        "first_name": "DENISE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1170DT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, KY

Sources for this page

Verify at the official NPI Registry.