Paul Lee Patterson II, OD
Individual provider Active NPI Optometrist · Campbellsville, KY
NPI 1497784755 · NPPES record last updated Feb 14, 2011
Key facts
- NPI
- 1497784755
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 1011DT (KY)
- Practice address
- 295 Campbellsville Bypass
Ste 1
Campbellsville, KY 42718 - Phone
- (270) 465-4677
- Fax
- (270) 465-4677
- NPI assigned
- Jun 30, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Southern College of Optometry, 1982
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
295 Campbellsville Byp
Campbellsville, KY 42718-7870
Phone (270) 465-4677
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060202000508 | KY | Practitioner - Optometry | 1456365097 | Practice locations: Campbellsville, KY; Russell Springs, KY |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Downey Eye Clinic, PLLC | Optometrist | Past |
Accepting new patients |
| John Kenyon American Eye Institute LLC | Past | Accepting new patients | |
| Paul L Patterson II OD PSC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1011DT | KY | Yes |
| Vision Therapy Optometrist | 152WV0400X | 1011DT | KY |
Addresses
Primary practice location
295 Campbellsville Bypass
Ste 1
Campbellsville, KY 42718
Mailing address
295 Campbellsville Bypass
Ste 1
Campbellsville, KY 42718
Phone (270) 465-4677
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0465020001 | Other | KY | MEDICARE DME |
| 77010114 | Medicaid | KY |
Other providers in Campbellsville, KY
- Brittney Padgett
- Jessica Nicole Paris
- Kitty Paris
- Mary Justine Parrott-Allen
- Patient AIDS Inc
- Patty-Cake Physical Therapy Inc
- Paul L Patterson II OD PSC
- Rhonda Pauley
- Alexis Pearish
- Bethany Perkins
All providers in Campbellsville, KY · Optometrist in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 14, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.