NPIMap

Organization Active NPI

Ky Doctors of Optometry, PLLC

Doing business as KY Doctors of Optometry

  • Eyewear Supplier
  • Hopkinsville, KY
National Provider Identifier
1477924884
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
KY DOCTORS OF OPTOMETRY, PLLC
Doing business as
KY Doctors of Optometry
Visionworks Doctors of Optometruy
Practice address
4135 Ft Campbell Boulevard
Hopkinsville, KY 42240-8706
Phone
(270) 887-5765
Fax
(270) 887-5766
NPI assigned
Oct 12, 2015
Last updated
Sep 11, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Authorized official

Name
Grant Rubesh, O.D.
Title
Owner
Phone
(726) 444-4078

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

4135 Ft Campbell Boulevard
Hopkinsville, KY 42240-8706

Mailing address

PO Box 846027
Dallas, TX 75284-6027
Phone (800) 340-0129

Other names 2

  • KY Doctors of Optometry Doing business as
  • Visionworks Doctors of Optometruy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151217002221 KY DME Supplier - Physician - Optometrist 0941108732 Practice locations: Hopkinsville, KY

Other NPIs with the same Medicare PAC ID 22

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 22

National Provider Directory

National Provider Directory
Tax ID family
Darren Patrick MD22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

Organizations that report the same tax identification number in the National Provider Directory.

View all 21

Locations

111 Jett Blvd
Ste 100
Frankfort, KY 40601
Phone (502) 695-6310

5047 Shelbyville Rd
St Matthews, KY 40207
Phone (502) 293-5340

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1444608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726012800000",
    "number": "1477924884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 846027",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752846027",
            "telephone_number": "800-340-0129",
            "fax_number": "210-524-6587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4135 FT CAMPBELL BOULEVARD",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "422408706",
            "telephone_number": "270-887-5765",
            "fax_number": "270-887-5766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KY DOCTORS OF OPTOMETRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-12",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A",
        "authorized_official_last_name": "RUBESH",
        "authorized_official_first_name": "GRANT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "726-444-4078",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KY Doctors of Optometry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Visionworks Doctors of Optometruy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hopkinsville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.