Organization Active NPI

Margena Keltner OD PSC

  • Optometrist
  • Mount Vernon, KY
National Provider Identifier
1275622037
Registry record updated Jun 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MARGENA KELTNER OD PSC
Practice address
205 Richmond St
Mt Vernon, KY 40456
Phone
(606) 256-3937
NPI assigned
Oct 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2011

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

Authorized official

Name
Mrs. Margena Lynn Keltner, OD
Title
President
Phone
(270) 849-3434

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

205 Richmond St
Mt Vernon, KY 40456

Mailing address

PO Box 1050
Mt Vernon, KY 40456
Phone (606) 256-3937

Other identifiers 1

IdentifierTypeStateIssuer
77000362MedicaidKY

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308096000000",
    "number": "1275622037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1050",
            "city": "MT VERNON",
            "state": "KY",
            "postal_code": "40456",
            "telephone_number": "606-256-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 RICHMOND ST",
            "city": "MT VERNON",
            "state": "KY",
            "postal_code": "40456",
            "telephone_number": "606-256-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARGENA KELTNER OD PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2011-06-15",
        "status": "A",
        "authorized_official_last_name": "KELTNER",
        "authorized_official_first_name": "MARGENA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "270-849-3434",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77000362",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.