Clinic Optical

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

102090 Issued in KY

Legal business name

CLINIC OPTICAL

Practice address

201 Park St
Bowling Green, KY 42101-1759

Phone

(270) 780-0594

Fax

(270) 783-3361

NPI assigned

Mar 29, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jennifer Wentworth, M.D.

Title

Ophthalmologist

Phone

(270) 780-0594

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210118400000",
    "number": "1508986167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 PARK ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011759",
            "telephone_number": "270-780-0594",
            "fax_number": "270-783-3361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 PARK ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011759",
            "telephone_number": "270-780-0594",
            "fax_number": "270-783-3361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINIC OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2008-05-07",
        "status": "A",
        "authorized_official_last_name": "WENTWORTH",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OPHTHALMOLOGIST",
        "authorized_official_telephone_number": "270-780-0594",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "156FX1100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Ophthalmic",
            "state": "KY",
            "license": "E82360",
            "primary": false
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "KY",
            "license": "102090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Billy Kevin Clemmons, D.M.D.
• Kera Clinard, RBT
• Christopher Caleb Cline
• Emilee Cline, LPA
• Mark Cline, LMT
• Clinical Reference Laboratory, Inc.
• Clubmd, LLC
• Chad M Coats, O.D.
• Paul Cofoid, M.D.
• Allison Coghill

• Eyewear Supplier in Bowling Green, KY
• Providers in Bowling Green, KY by specialty
• Eyewear Supplier in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2008; 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.