NPIMap

Organization Active NPI

Tri-State Centers for Sight, Inc

  • Ophthalmology Physician
  • Covington, KY
National Provider Identifier
1477950269
Registry record updated Nov 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
TRI-STATE CENTERS FOR SIGHT, INC
Practice address
802 Scott St
Covington, KY 41011-2420
Phone
(859) 341-4525
Fax
(859) 341-4993
NPI assigned
Nov 24, 2014
Last updated
Nov 26, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2014

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

Authorized official

Name
Daniel A Nordloh
Title
Ceo
Phone
(859) 344-2061

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

802 Scott St
Covington, KY 41011-2420

Mailing address

2865 Chancellor Dr
Suite 215
Crestview Hills, KY 41017-3912
Phone (859) 344-2079

Other identifiers 2

IdentifierTypeStateIssuer
65925760MedicaidKY
77903425MedicaidKY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040219000102 KY Part B Supplier - Clinic/Group Practice 7113812090 Receives reassigned benefits from 31 practitioners
17 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mount Sterling, KY; Versailles, KY; Paintsville, KY; Morehead, KY; Middlesboro, KY; Maysville, KY; Lexington, KY; London, KY…

Other NPIs on the same Medicare enrollment 17

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 17

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1416787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416960000000",
    "number": "1477950269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2865 CHANCELLOR DR",
            "address_2": "SUITE 215",
            "city": "CRESTVIEW HILLS",
            "state": "KY",
            "postal_code": "410173912",
            "telephone_number": "859-344-2079",
            "fax_number": "859-581-7207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 SCOTT ST",
            "city": "COVINGTON",
            "state": "KY",
            "postal_code": "410112420",
            "telephone_number": "859-341-4525",
            "fax_number": "859-341-4993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-STATE CENTERS FOR SIGHT, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-24",
        "last_updated": "2014-11-26",
        "status": "A",
        "authorized_official_last_name": "NORDLOH",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "859-344-2061"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65925760",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77903425",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2014; 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.