Organization Active NPI

Physicians Eye Center of Owensboro, PSC

  • Ophthalmology Physician
  • Owensboro, KY
National Provider Identifier
1245239037
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
PHYSICIANS EYE CENTER OF OWENSBORO, PSC
Practice address
2845 Farrell Crescent
Owensboro, KY 42303
Phone
(270) 926-3297
Fax
(270) 926-7325
NPI assigned
Jul 14, 2005
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Jennifer D. Latham
Title
Office Manager
Phone
(270) 926-3297

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X
Ophthalmology Physician 207W00000X KY
Ophthalmology Physician 207W00000X Primary

Addresses

Primary practice location

2845 Farrell Crescent
Owensboro, KY 42303

Mailing address

2845 Farrell Crescent
Owensboro, KY 42303
Phone (270) 926-3297

Other identifiers 1

IdentifierTypeStateIssuer
65905556MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050518000596 KY Part B Supplier - Clinic/Group Practice 5890736094 Receives reassigned benefits from 4 practitioners
Practice locations: Hartford, KY; Madisonville, KY; Owensboro, KY; Powderly, KY
O20100930013767 KY DME Supplier - Physician - OphthalmologyDME Supplier - Optician 5890736094 Practice locations: Owensboro, KY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Physicians Eye Center of Owensboro,2845 Farrell Crescent, Owensboro, KY 42303-1393(270) 926-3297 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Jan 1, 1990

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1245239037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2845 FARRELL CRESCENT",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "42303",
            "telephone_number": "270-926-3297",
            "fax_number": "270-926-7325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2845 FARRELL CRESCENT",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "42303",
            "telephone_number": "270-926-3297",
            "fax_number": "270-926-7325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS EYE CENTER OF OWENSBORO, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-14",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "LATHAM",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "270-926-3297"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65905556",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Owensboro, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.