Active NPI
Karen Elaine Manko, O.D.
- Optometrist
- Fort Mitchell, KY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1904DT
- Practice address
- 2174 Dixie Hwy
Fort Mitchell, KY 41017-2972 - Phone
- (859) 341-2566
- Fax
- (859) 341-2568
- NPI assigned
- Jul 27, 2012
- Sex
- Female
- Sole proprietor
- No
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 | 1904DT | KY | Primary |
Addresses
Primary practice location
2174 Dixie Hwy
Fort Mitchell, KY 41017-2972
Mailing address
178 Picketts Charge
Fort Thomas, KY 41075-1469
Phone (859) 341-2566
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1904DT | Other | KY | STATE LICENSE |
| 7100217150 | 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 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120807000739 | KY | Practitioner - Optometry | 2163678178 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Ohio State University - College of Optometry, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Dr Shewmaker and Associates Optometrists Inc
Practice addresses (Care Compare)
2174 Dixie Hwy
Suite a
Fort Mitchell, KY 41017-2972
Phone (859) 341-2566
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1904DT | KY | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr Shewmaker & Associates Optometrists Inc | Optometrist | Current | Accepting new patients |
| Dr Shewmaker & Associates Optometrists Inc | Optometrist | Past | Accepting new patients |
Locations
1114 Fashion Ridge Rd
Dry Ridge, KY 41035
Phone (859) 824-4415
2174 Dixie Hwy
Ft Mitchell, KY 41017
Phone (606) 341-2566
2174 Dixie Hwy
Ste A
Ft Mitchell, KY 41017
Phone (859) 341-2566
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.
-
- Optometrist
- Fort Mitchell, KY
- NPI 1871641332
KY, Optometrist
-
- Optometrist
- Dry Ridge, KY
- NPI 1801949227
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366329600000",
"number": "1487900494",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "178 PICKETTS CHARGE",
"city": "FORT THOMAS",
"state": "KY",
"postal_code": "410751469",
"telephone_number": "859-341-2566",
"fax_number": "859-341-2568"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2174 DIXIE HWY",
"city": "FORT MITCHELL",
"state": "KY",
"postal_code": "410172972",
"telephone_number": "859-341-2566",
"fax_number": "859-341-2568"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANKO",
"first_name": "KAREN",
"middle_name": "ELAINE",
"name_prefix": "Ms.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-27",
"last_updated": "2013-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "KY",
"license": "1904DT",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "1904DT",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7100217150",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fort Mitchell, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2013; 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.