Individual provider Active NPI

Sarah Kaitlin King, O.D.

  • Optometrist
  • Berea, KY
National Provider Identifier
1447505532
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1899DT Issued in KY
Practice address
854 Ridgewood Dr.
Berea, KY 40403-9814
Phone
(859) 986-7027
Fax
(859) 986-4749
NPI assigned
Jul 16, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1899DT KY Primary

Addresses

Primary practice location

854 Ridgewood Dr.
Berea, KY 40403-9814

Mailing address

109 Boone St
Berea, KY 40403-1603
Phone (859) 986-7027

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120828000082 KY Practitioner - Optometry 2264689298 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2012
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)

854 Ridgewood Dr
Berea, KY 40403-9814
Phone (859) 986-7027

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery21

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Gary E. King Optometrist PSC CurrentSince Sep 1, 2012 Accepting new patients
Kentucky Institute for Eye Health & Surgery Past Accepting new patients

Locations

109 Boone St
Berea, KY 40403
Phone (606) 986-6598

854 Ridgewood Dr
Berea, KY 40403
Phone (606) 666-9393

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1342396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1447505532",
    "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": "SARAH",
        "middle_name": "KAITLIN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-16",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1899DT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berea, KY

Sources for this page

Verify at the official NPI Registry.