Organization Active NPI

Max M Downey OD PSC

  • Optometrist
  • Columbia, KY
National Provider Identifier
1487697298
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MAX M DOWNEY OD PSC
Practice address
1463 Campbellsville Rd
Columbia, KY 42728-2263
Phone
(270) 384-6043
Fax
(270) 384-0672
NPI assigned
Jun 13, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Jacob Burton, OD
Title
Owner
Phone
(270) 384-6043

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

National Provider Directory

National Provider Directory

Locations

360 Keen St
#300
Burkesville, KY 42717
Phone (270) 864-2390

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

1463 Campbellsville Rd
Columbia, KY 42728-2263

Mailing address

1463 Campbellsville Rd
Columbia, KY 42728-2263
Phone (270) 384-6043

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
77009793MedicaidKY
77904126MedicaidKY

Other names 1

NPPES NPI Registry
  • Downey eye clinic Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 10, 2024.

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717977600000",
    "number": "1487697298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1463 CAMPBELLSVILLE RD",
            "city": "COLUMBIA",
            "state": "KY",
            "postal_code": "427282263",
            "telephone_number": "270-384-6043",
            "fax_number": "270-384-0672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1463 CAMPBELLSVILLE RD",
            "city": "COLUMBIA",
            "state": "KY",
            "postal_code": "427282263",
            "telephone_number": "270-384-6043",
            "fax_number": "270-384-0672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAX M DOWNEY OD PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-13",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A",
        "authorized_official_last_name": "BURTON",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-384-6043",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77009793",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77904126",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Downey eye clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbia, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.