NPIMap

Organization Active NPI

Clarkson Optometry Midwest Inc.

Doing business as 20/20 EyeCare

  • Optometrist
  • Louisville, KY
National Provider Identifier
1548207434
Registry record updated Jun 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
CLARKSON OPTOMETRY MIDWEST INC.
Doing business as
20/20 EyeCare
Practice address
10639 Dixie Hwy
Louisville, KY 40272-4349
Phone
(636) 200-4393
Fax
(502) 736-4490
NPI assigned
Jun 1, 2006
Last updated
Jun 7, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2019

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

Authorized official

Name
James WachterNPI 1689670697
Title
Cmo
Phone
(636) 200-4393

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

10639 Dixie Hwy
Louisville, KY 40272-4349

Mailing address

PO Box 207170
Dallas, TX 75320-7156
Phone (636) 200-4393

Other identifiers 1

IdentifierTypeStateIssuer
77903987MedicaidKY

Other names 1

  • 20/20 EyeCare Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559865600000",
    "number": "1548207434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 207170",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753207156",
            "telephone_number": "636-200-4393",
            "fax_number": "636-527-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10639 DIXIE HWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402724349",
            "telephone_number": "636-200-4393",
            "fax_number": "502-736-4490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARKSON OPTOMETRY MIDWEST INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2019-06-07",
        "status": "A",
        "authorized_official_last_name": "WACHTER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "636-200-4393"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77903987",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "20/20 EyeCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2019; 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.