Amanda M Ballard, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1792DT Issued in KY

Practice address

325 W Walnut St
Ste400
Lebanon, KY 40033-1377

Phone

(502) 955-2020

Fax

(502) 736-4490

NPI assigned

Oct 12, 2009

Last updated

Jun 14, 2010By the provider in NPPES

Sex

Female

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

Other names 1

• Amanda M Mattingly Former name

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Indiana University - School of Optometry, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Downey Eye Clinic, PLLCGroup PAC ID 9830561117, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amandaballard@direct.eyecare-partners.com

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.

• Downey Eye Clinic, PLLC

  dba Downey Eye Clinic

  • Optometrist
  • Columbia, KY
  • NPI 1841253424
  Medicare reassignment Care Compare group
• Clarkson Optometry Midwest Inc

  dba Clarkson Eyecare

  • Optometrist
  • Centerville, OH
  • NPI 1073917597

  KY

  Medicare reassignment NPD
• Clarkson Optometry Midwest Inc

  dba 20/20 EyeCare

  • Optometrist
  • Lebanon, KY
  • NPI 1366520702
  NPD
• Downey Eye Clinic, PLLC

  • Optometrist
  • Russell Springs, KY
  • NPI 1083406490
  NPD
• Clarkson Optometry Midwest Inc

  dba Clarkson Eyecare

  • Optometrist
  • Clarksville, IN
  • NPI 1295772143
  NPD

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

{
    "created_epoch": "1255305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276473600000",
    "number": "1285969055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5855 RELIABLE PKWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606860001",
            "telephone_number": "502-955-2020",
            "fax_number": "502-736-4490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 W WALNUT ST",
            "address_2": "STE400",
            "city": "LEBANON",
            "state": "KY",
            "postal_code": "400331377",
            "telephone_number": "502-955-2020",
            "fax_number": "502-736-4490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLARD",
        "first_name": "AMANDA",
        "middle_name": "M",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-12",
        "last_updated": "2010-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1792DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100110940",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "MATTINGLY",
            "middle_name": "M",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Angelica Anderson, APRN
• Emmanuel Awah
• Daniel Earl Bailey Jr., M.D.
• Cheryl L Baker, MD
• Cody Evan Baker, TCADC
• Dolores Ballard, LCSW
• Margaret Ballard, FNP
• Barry T Bartley, PHARMD
• Jennifer Bartley, APRN
• Mary Elizabeth Batt, BSN,RN, LMT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2010; 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.
• 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.