Professional Eyecare, P.S.C.

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

PROFESSIONAL EYECARE, P.S.C.

Practice address

341 Court St
Paintsville, KY 41240-1051

Phone

(606) 789-4675

Fax

(606) 789-3262

NPI assigned

Mar 15, 2007

Last updated

Dec 10, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Randall Mann, OD

Title

Owner

Phone

(606) 789-4675

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575936000000",
    "number": "1639203474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 COURT ST",
            "city": "PAINTSVILLE",
            "state": "KY",
            "postal_code": "412401051",
            "telephone_number": "606-789-4675",
            "fax_number": "606-789-3262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 COURT ST",
            "city": "PAINTSVILLE",
            "state": "KY",
            "postal_code": "412401051",
            "telephone_number": "606-789-4675",
            "fax_number": "606-789-3262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL EYECARE, P.S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2019-12-10",
        "certification_date": "2019-12-10",
        "status": "A",
        "authorized_official_last_name": "MANN",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "606-789-4675",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77900660",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMWA HEALTH & RETIREMENT",
            "identifier": "0842338",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.