Active NPI
Kelly Tarter
- Optometrist
- Greenville, KY
National Provider Identifier
1407895246
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- KY1046
- Practice address
- 224 Hopkinsville St
Greenville, KY 42345-1214 - Phone
- (270) 338-2400
- Fax
- (270) 338-2402
- NPI assigned
- Jun 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | KY1046 | KY | Primary |
Addresses
Primary practice location
224 Hopkinsville St
Greenville, KY 42345-1214
Mailing address
224 Hopkinsville St
Greenville, KY 42345-1214
Phone (270) 338-2400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 77010460 | Medicaid | KY |
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
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060206000208 | KY | Practitioner - Optometry | 2860406261 | Practice locations: Greenville, KY |
| O20100930010997 | KY | DME Supplier - Physician - Optometrist | 8426177601 | Practice locations: Greenville, KY |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Southern College of Optometry, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
224 Hopkinsville St
Greenville, KY 42345-1214
Phone (270) 338-2400
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 43 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| KY1046 | KY | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776211200000",
"number": "1407895246",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "224 HOPKINSVILLE ST",
"city": "GREENVILLE",
"state": "KY",
"postal_code": "423451214",
"telephone_number": "270-338-2400",
"fax_number": "270-338-2402"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "224 HOPKINSVILLE ST",
"city": "GREENVILLE",
"state": "KY",
"postal_code": "423451214",
"telephone_number": "270-338-2400",
"fax_number": "270-338-2402"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TARTER",
"first_name": "KELLY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-06",
"last_updated": "2026-04-15",
"certification_date": "2026-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "KY",
"license": "KY1046",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "77010460",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greenville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2026; 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.