Gary E King, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

0865DT Issued in KY

Practice address

854 Ridgewood Dr.
Berea, KY 40403-9814

Phone

(859) 986-7027

Fax

(859) 986-4749

NPI assigned

Oct 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Illinois College of Optometry at Chicago, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dr. Gary E. King Optometrist PSCGroup PAC ID 8628138229, 5 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Dr. Gary E. King Optometrist PSC

  • Clinic/Center
  • Berea, KY
  • NPI 1588819080
  Medicare reassignment Care Compare group Authorized official
• Kentucky Institute for Eye Health & Surgery

  • Durable Medical Equipment & Medical Supplies
  • Middlesboro, KY
  • NPI 1013015510
  NPD (past)

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1336229715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 BOONE ST",
            "city": "BEREA",
            "state": "KY",
            "postal_code": "404031603",
            "telephone_number": "859-986-7027",
            "fax_number": "859-986-4749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "854 RIDGEWOOD DR.",
            "city": "BEREA",
            "state": "KY",
            "postal_code": "404039814",
            "telephone_number": "859-986-7027",
            "fax_number": "859-986-4749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "GARY",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "856DT",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "0865DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77008654",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maxine Lynn Keller, LCADC, CADC
• Louis Rhett Kenny, D.C.
• Kentucky Dental Anesthesia Services
• Kentucky Hospice Network
• Kentucky Institute for Eye Health & Surgery
• Sarah Kaitlin King, O.D.
• Kimberly J Kirby
• Jennifer Kirk, DI
• Courtney Ashley Carta Kleppinger, PHARM.D., R.PH.
• James Gregory Knight, RPH

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; 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.