Jeremy Lee Penn, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2225DT Issued in KY

Practice address

308 N Main St
Cynthiana, KY 41031-1210

Phone

(859) 234-1424

Fax

(859) 234-5463

NPI assigned

May 26, 2021

Last updated

Aug 9, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Myeyedr Optometry of Kentucky PLLCGroup PAC ID 1951638964, 19 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Myeyedr Optometry of Kentucky, PLLC

  dba MyEyeDr.

  • Optometrist
  • Cold Spring, KY
  • NPI 1255990966
  Medicare reassignment Care Compare group NPD
• Myeyedr Optometry of Kentucky, PLLC

  dba MyEyeDr.

  • Optometrist
  • Paris, KY
  • NPI 1144999756
  NPD
• Myeyedr Optometry of Kentucky, PLLC

  dba MyEyeDr.

  • Optometrist
  • Cynthiana, KY
  • NPI 1154090769
  NPD
• Myeyedr Optometry of Kentucky, PLLC

  • Optometrist
  • Lexington, KY
  • NPI 1265399620
  NPD
• Myeyedr Optometry of Indiana, LLC

  dba MyEyeDr.

  • Optometrist
  • Schererville, IN
  • NPI 1043779457
  NPD (past)

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

{
    "created_epoch": "1621987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1568037059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 N MAIN ST",
            "city": "CYNTHIANA",
            "state": "KY",
            "postal_code": "410311210",
            "telephone_number": "859-234-1424",
            "fax_number": "859-234-5463"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1543 Main St",
            "address_purpose": "LOCATION",
            "city": "Paris",
            "state": "KY",
            "postal_code": "403611203",
            "country_code": "US",
            "telephone_number": "859-987-7077",
            "fax_number": "859-987-7064",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENN",
        "first_name": "JEREMY",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-26",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "2225DT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janet Olson
• Anna L Otis, MSW, CSW
• Parke Physicians PLLC
• Parkside Manor I LLC
• Parkside Manor LLC
• John Francis Peppin, D.O.
• James Pettey, MD
• John Pidakala, MD
• Sofie Lavinia Pinney, DPM
• Ashley Plowman, DPT

• Optometrist in Cynthiana, KY
• Providers in Cynthiana, KY by specialty
• Optometrist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2024; 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.

Verify at the official NPI Registry.