Organization Active NPI

Ross & Birge Inc

  • Optometrist
  • Tompkinsville, KY
National Provider Identifier
1386776169
Registry record updated Jan 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
ROSS & BIRGE INC
Practice address
22 Executive Dr
Tompkinsville, KY 42167-7478
Phone
(270) 487-5741
Fax
(270) 487-9664
NPI assigned
Mar 9, 2007
Last updated
Jan 7, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2010

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

Authorized official

Name
Stephen K Birge, O.D.
Title
Vice-President
Phone
(270) 487-5741

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

22 Executive Dr
Tompkinsville, KY 42167-7478

Mailing address

22 Executive Dr
Tompkinsville, KY 42167-7478
Phone (270) 487-5741

Other identifiers 11

IdentifierTypeStateIssuer
1386776169OtherKYMEDICARE GROUP NPI
1720086267OtherKYNPI NUMBERS
77000933MedicaidKY
5940OtherKYDAVIS VISION
1205834587OtherKYNPI NUMBERS
1801894340OtherKYNPI NUMBERS
77011013MedicaidKY
410049286OtherKYRAILROAD MEDICARE
77007557MedicaidKY
1386776169OtherKYMEDICAID GROUP NPI
03322OtherKYSPECTERA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20051117000378 KY Part B Supplier - Clinic/Group Practice 2365461415 Receives reassigned benefits from 3 practitioners
Practice locations: Tompkinsville, KY
O20100930021951 KY DME Supplier - Physician - Optometrist 2365461415 Practice locations: Tompkinsville, KY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Ross & Birge Inc22 Executive Dr, Tompkinsville, KY 42167-7478(270) 487-5741 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Dec 21, 2001

National Provider Directory

National Provider Directory

Locations

22 Executive Dr
Tompkinsville, KY 42167
Phone (270) 487-5741

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262822400000",
    "number": "1386776169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 EXECUTIVE DR",
            "city": "TOMPKINSVILLE",
            "state": "KY",
            "postal_code": "421677478",
            "telephone_number": "270-487-5741",
            "fax_number": "270-487-9664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 EXECUTIVE DR",
            "city": "TOMPKINSVILLE",
            "state": "KY",
            "postal_code": "421677478",
            "telephone_number": "270-487-5741",
            "fax_number": "270-487-9664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSS & BIRGE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2010-01-07",
        "status": "A",
        "authorized_official_last_name": "BIRGE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "270-487-5741",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NPI",
            "identifier": "1386776169",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI  NUMBERS",
            "identifier": "1720086267",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77000933",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS VISION",
            "identifier": "5940",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NUMBERS",
            "identifier": "1205834587",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NUMBERS",
            "identifier": "1801894340",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77011013",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410049286",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77007557",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP NPI",
            "identifier": "1386776169",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "03322",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tompkinsville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.