NPIMap

Organization Active NPI

Calvert Opthalmology PSC

  • Ophthalmology Physician
  • Hopkinsville, KY
National Provider Identifier
1508036831
Registry record updated Jul 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
36511 Issued in KY
Legal business name
CALVERT OPTHALMOLOGY PSC
Practice address
100 Keeton Dr.
Hopkinsville, KY 42240-1746
Phone
(270) 886-2050
Fax
(270) 886-2007
NPI assigned
Mar 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2020

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

Authorized official

Name
Dr. Harold M Calvert I, M.D.NPI 1396737219
Title
President
Phone
(270) 886-2050

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207W00000X 36511 KY Primary
Ophthalmology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207W00000X MD0000035976 TN

Addresses

Primary practice location

100 Keeton Dr.
Hopkinsville, KY 42240-1746

Mailing address

100 Keeton Dr
Hopkinsville, KY 42240
Phone (270) 886-2050

Other identifiers 3

IdentifierTypeStateIssuer
180045298OtherTNRAILROAD MEDICARE
3879306MedicaidTN
64031669MedicaidKY

Other names 1

  • CALVERT OPHTHALMOLOGY CENTER Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051026000445 KY Part B Supplier - Clinic/Group Practice 5193740959 Receives reassigned benefits from 1 practitioner
Practice locations: Hopkinsville, KY; Madisonville, KY

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Tax ID family
Calvert Ophthalmology Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

1350 S Main St
Madisonville, KY 42431
Phone (270) 821-6241

200 Clinic Dr
Fl 1
Madisonville, KY 42431
Phone (270) 825-6680

2801 Wilma Rudolph Blvd
Ste 655
Clarksville, TN 37040

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1204502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593993600000",
    "number": "1508036831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KEETON DR",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "42240",
            "telephone_number": "270-886-2050",
            "fax_number": "270-886-2007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 KEETON DR.",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "422401746",
            "telephone_number": "270-886-2050",
            "fax_number": "270-886-2007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALVERT OPTHALMOLOGY PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-03",
        "last_updated": "2020-07-06",
        "certification_date": "2020-07-06",
        "status": "A",
        "authorized_official_last_name": "CALVERT",
        "authorized_official_first_name": "HAROLD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "270-886-2050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "I",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "KY",
            "license": "36511",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "TN",
            "license": "MD0000035976",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "180045298",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3879306",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64031669",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CALVERT OPHTHALMOLOGY CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CALVERT OPHTHALMOLOGY CENTER",
            "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 Jul 6, 2020; 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.