Individual provider Active NPI

Rebecca Conrad, OD

  • Optometrist
  • Mt Sterling, KY
National Provider Identifier
1316460801
Registry record updated Jul 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2061DT Issued in KY
Practice address
25 Sterling Way Ste C
Mount Sterling, KY 40353-1174
Phone
(859) 498-4800
NPI assigned
Jul 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2061DT KY Primary

Addresses

Primary practice location

25 Sterling Way Ste C
Mount Sterling, KY 40353-1174

Mailing address

2391 Sir Barton Way Apt 1128
Lexington, KY 40509-2564

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
I20170912003086 KY Practitioner - Optometry 9133492234 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bluegrass Vision Group PLLCGroup PAC ID 8022385848, 4 clinicians

Practice addresses (Care Compare)

25 Sterling Way
Suite C
Mount Sterling, KY 40353-1174
Phone (859) 498-4800

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bluegrass Vision Group of Hamburg PLLC Optometrist CurrentSince Nov 4, 2023 Accepting new patients
Bluegrass Vision Group PLLC Optometrist CurrentSince Jul 31, 2017 Accepting new patients
KSM, PLLC Optometrist CurrentSince Nov 4, 2023 Accepting new patients

Locations

2716 Old Rosebud Rd
Ste 130
Lexington, KY 40509
Phone (859) 327-3701

25 Sterling Way
Ste C
Mt Sterling, KY 40353
Phone (859) 498-4800

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1500249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500249600000",
    "number": "1316460801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2391 SIR BARTON WAY APT 1128",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405092564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 STERLING WAY STE C",
            "city": "MOUNT STERLING",
            "state": "KY",
            "postal_code": "403531174",
            "telephone_number": "859-498-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONRAD",
        "first_name": "REBECCA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-17",
        "last_updated": "2017-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "2061DT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Sterling, KY

Sources for this page

Verify at the official NPI Registry.