NPIMap

Individual provider Active NPI

Kevin Burt, OD

  • Optometrist
  • Bowling Green, KY
National Provider Identifier
1295899318
Registry record updated Oct 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1578DT Issued in KY
Practice address
2724 Nashville Rd
Bowling Green, KY 42101-4000
Phone
(270) 781-5111
Fax
(270) 936-6026
NPI assigned
Dec 21, 2006
Last updated
Oct 5, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1578DT KY Primary

Addresses

Primary practice location

2724 Nashville Rd
Bowling Green, KY 42101-4000

Mailing address

201 Park St
Bowling Green, KY 42101-1759
Phone (270) 781-5111

Other identifiers 1

IdentifierTypeStateIssuer
77000958MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090624000274 KY Practitioner - Optometry 7911058466 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ky Doctors of Optometry, PLLCGroup PAC ID 0941108732, 64 clinicians

Practice addresses (Care Compare)

2608 Scottsville Rd
Bowling Green, KY 42104-4406
Phone (270) 782-2025

4135 Fort Campbell Blvd
Hopkinsville, KY 42240-8706
Phone (270) 887-5765

500 Winchester Ave
Suite 810
Ashland, KY 41101-7362
Phone (606) 324-3672

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1578KYMDClinical Social Worker
1578DTKYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ky Doctors of Optometry, PLLC Optometrist Past Accepting new patients
Ky Doctors of Optometry, PLLC Optometrist Past Accepting new patients
Tri-State Doctors of Optometrist Past Accepting new patients
Ky Doctors of Optometry, PLLC Past Accepting new patients
Ky Doctors of Optometry, PLLC Optometrist Past Accepting new patients
Ky Doctors of Optometry, PLLC Optometrist Past Accepting new patients
Ky Doctors of Optometry, PLLC Past Accepting new patients
Ky Doctors of Optometry, PLLC Optometrist Past Accepting new patients
Ky Doctors of Optometry, PLLC Optometrist Past Accepting new patients
Ky Doctors of Optometry, PLLC Optometrist Past Accepting new patients
Ky Doctors of Optometry, PLLC Optometrist Past Accepting new patients
Ky Doctors of Optometry, PLLC Optometrist Past Accepting new patients
Ky Doctors of Optometry, PLLC Optometrist Past Accepting new patients
Ky Doctors of Optometry, PLLC Optometrist Past Accepting new patients

Organizations & group practices 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475625600000",
    "number": "1295899318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 PARK ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011759",
            "telephone_number": "270-781-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2724 NASHVILLE RD",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421014000",
            "telephone_number": "270-781-5111",
            "fax_number": "270-936-6026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURT",
        "first_name": "KEVIN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2016-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1578DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77000958",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

Verify at the official NPI Registry.