Fred Klutts Jr., OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

0830DT Issued in KY

Practice address

3910 Hinkleville Rd
Paducah, KY 42001-9017

Phone

(270) 443-2090

Fax

(270) 444-2086

NPI assigned

Dec 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474934400000",
    "number": "1255496170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11103 WEST AVE",
            "address_2": "SUITE 6",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782131370",
            "telephone_number": "210-524-6663",
            "fax_number": "210-524-6587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3910 HINKLEVILLE RD",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420019017",
            "telephone_number": "270-443-2090",
            "fax_number": "270-444-2086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUTTS",
        "first_name": "FRED",
        "name_suffix": "Jr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-22",
        "last_updated": "2016-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "0830DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77008308",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stacy Kirkham, LCADC
• Hannah Klein, LCSW
• Kristina Lynn Kline, MOTR/L
• Jeremy Lee Klope, M.D.
• Martha June Kloss, ARNP
• Aymee Knight
• Kimberley Sue Knight, APRN
• Robert Knott
• Michael Landers Knox, M.D.
• Shajuanta Knox

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.