Clarkson Optometry Midwest Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

CLARKSON OPTOMETRY MIDWEST INC.

Practice address

544 Conestoga Parkway
Suite 17
Shepherdsville, KY 40165-6081

Phone

(636) 200-4393

Fax

(502) 736-4490

NPI assigned

Jun 1, 2006

Organization subpart

No

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

Authorized official

Name

James Wachter

Title

Cmo

Phone

(636) 200-4393

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• 20/20 EyeCare Doing business as

Locations

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559865600000",
    "number": "1366489189",
    "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": "753207156",
            "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": "544 CONESTOGA PARKWAY",
            "address_2": "SUITE 17",
            "city": "SHEPHERDSVILLE",
            "state": "KY",
            "postal_code": "401656081",
            "telephone_number": "636-200-4393",
            "fax_number": "502-736-4490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARKSON OPTOMETRY MIDWEST INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2019-06-07",
        "status": "A",
        "authorized_official_last_name": "WACHTER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "636-200-4393"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77903953",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "20/20 EyeCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Central Kentucky Optometric Associates PSC
• Katie Louise Chasteen Mason, LMT
• Thomas Cherry, LMFT
• Bryana Elizabeth Clark, PHARMD
• Jessica Lynn Clark, PHARMD
• Cami Coke, PHARMD
• Maressa Coley, NP
• Allison Rae Collins, PA-C
• Colonial House I LLC
• Comprehensive Foot & Ankle Centers

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.