Individual provider Active NPI

Forest Tyler Pope, OD

  • Optometrist
  • Lexington, KY
National Provider Identifier
1306578554
Registry record updated Jun 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2283DT Issued in KY
Practice address
150 W Lowry LN
Lexington, KY 40503-3020
Phone
(859) 436-6632
NPI assigned
Jun 27, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2283DT KY Primary

Addresses

Primary practice location

150 W Lowry LN
Lexington, KY 40503-3020

Mailing address

4070 Victoria Way Apt 23
Lexington, KY 40515-4691
Phone (859) 797-3643

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240202002222 KY Practitioner - Optometry 3476906769 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Amedco Kentucky PLLCGroup PAC ID 7911142310, 4 clinicians

Practice addresses (Care Compare)

1800 Old Lebanon Rd
Campbellsville, KY 42718-9663
Phone (270) 789-2023

2720 Old Rosebud Rd
Suite 110
Lexington, KY 40509-8005
Phone (859) 373-0300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2283DTKYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Amedco Kentucky PLLC Optometrist CurrentSince Nov 1, 2023 Accepting new patients

Locations

1800 Old Lebanon Rd
Campbellsvlle, KY 42718
Phone (270) 465-5361

2720 Old Rosebud Rd
Ste 110
Lexington, KY 40509
Phone (859) 373-0300

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1656288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656288000000",
    "number": "1306578554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4070 VICTORIA WAY APT 23",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405154691",
            "telephone_number": "859-797-3643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 W LOWRY LN",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405033020",
            "telephone_number": "859-436-6632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPE",
        "first_name": "FOREST",
        "middle_name": "TYLER",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-27",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "2283DT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.