Organization Active NPI

West End Eye Care, LTD.

  • Optometrist
  • Paducah, KY
National Provider Identifier
1578972113
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1958DT Issued in KY
Legal business name
WEST END EYE CARE, LTD.
Practice address
2559 New Holt Rd
Paducah, KY 42001-7503
Phone
(270) 558-4741
Fax
(270) 558-4742
NPI assigned
Aug 7, 2014
Last updated
Sep 19, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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

Authorized official

Name
Dr. Canaan M Montgomery, ODNPI 1225442288
Title
President
Phone
(270) 558-4741

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1958DT KY Primary

Addresses

Primary practice location

2559 New Holt Rd
Paducah, KY 42001-7503

Mailing address

2559 New Holt Rd
Paducah, KY 42001-7503
Phone (270) 558-4741

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141007002737 KY Part B Supplier - Clinic/Group Practice 2961622386 Receives reassigned benefits from 2 practitioners
Practice locations: Paducah, KY

National Provider Directory

National Provider Directory

Locations

2559 New Holt Rd
Paducah, KY 42001
Phone (270) 519-2821

4570 Pecan Dr
Ste C
Paducah, KY 42001
Phone (270) 519-2821

Practitioners & affiliated clinicians

Practitioners 2

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": "1407369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726704000000",
    "number": "1578972113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2559 NEW HOLT RD",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420017503",
            "telephone_number": "270-558-4741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2559 NEW HOLT RD",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420017503",
            "telephone_number": "270-558-4741",
            "fax_number": "270-558-4742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST END EYE CARE, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-07",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A",
        "authorized_official_last_name": "MONTGOMERY",
        "authorized_official_first_name": "CANAAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "270-558-4741",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1958DT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2024; 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.