Mary Elizabeth Graham

Primary specialty

OptometristTaxonomy code 152W00000X

License

2349DT Issued in KY

Practice address

6828 Bardstown Rd
Louisville, KY 40291-3050

Phone

(502) 231-2020

NPI assigned

May 1, 2023

Last updated

Jan 16, 2025By 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 2

Addresses

Other names 1

• Mary Elizabeth Holder 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, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clarkson Optometry Midwest IncGroup PAC ID 0749504165, 78 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mollyholder@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.

• Clarkson Optometry Midwest Inc

  dba Clarkson Eyecare

  • Optometrist
  • Centerville, OH
  • NPI 1073917597

  KY

  Medicare reassignment Care Compare group NPD
• Clarkson Optometry Midwest Inc

  dba 20/20 EyeCare

  • Optometrist
  • Lebanon, KY
  • NPI 1366520702
  NPD
• Clarkson Optometry Midwest Inc

  dba Clarkson Eyecare

  • Optometrist
  • Clarksville, IN
  • NPI 1295772143
  NPD
• 20-20 Eyecare PSC

  • Optometrist
  • Louisville, KY
  • NPI 1710924949
  NPD (past)

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

{
    "created_epoch": "1682899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1356030993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 207170",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753207170",
            "telephone_number": "636-200-4393",
            "fax_number": "636-527-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6828 BARDSTOWN RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402913050",
            "telephone_number": "502-231-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10232 Westport Rd",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402412148",
            "country_code": "US",
            "telephone_number": "502-339-2042",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "544 Conestoga Pkwy Ste 17",
            "address_purpose": "LOCATION",
            "city": "Shepherdsville",
            "state": "KY",
            "postal_code": "401655677",
            "country_code": "US",
            "telephone_number": "502-955-2020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10639 Dixie Hwy",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402724349",
            "country_code": "US",
            "telephone_number": "502-933-9200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-01",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "2349DT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "HOLDER",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kaitlyn Darlene Graham
• Kelly Rae Graham, NP
• Kevin Alexander Graham, M.D.
• Kristine Graham
• Lauren Graham
• Michael Graham, OTR
• Rebecca Marie Graham, OTR
• Samuel Lyle Graham III, M.D.
• Stephen Lee Graham, D.C.
• Tamara Graham, MSN, FNP-C

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; 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.