Active NPI
Retina Associates, PSC
- Ophthalmology Physician
- Louisville, KY
National Provider Identifier
1639306665
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 41088
- Legal business name
- RETINA ASSOCIATES, PSC
- Practice address
- 1536 Story Ave
Louisville, KY 40206-1738 - Phone
- (502) 589-1500
- Fax
- (502) 589-1556
- NPI assigned
- Jun 17, 2009
- Last updated
- Mar 10, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Mark Leon Jaggers, M.D.
- Title
- Employee Doctor
- Phone
- (502) 589-1500
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 41088 | KY | Primary |
Addresses
Primary practice location
1536 Story Ave
Louisville, KY 40206-1738
Mailing address
1536 Story Ave
Louisville, KY 40206-1738
Phone (502) 589-1500
National Provider Directory
National Provider Directory- Tax ID family
- Eye Care Institute
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
Locations
1553 Highway 44 E
Shepherdsvlle, KY 40165
Phone (502) 955-7311
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245196800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1268179200000",
"number": "1639306665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1536 STORY AVE",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402061738",
"telephone_number": "502-589-1500",
"fax_number": "502-589-1556"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1536 STORY AVE",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402061738",
"telephone_number": "502-589-1500",
"fax_number": "502-589-1556"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RETINA ASSOCIATES, PSC",
"organizational_subpart": "NO",
"enumeration_date": "2009-06-17",
"last_updated": "2010-03-10",
"status": "A",
"authorized_official_last_name": "JAGGERS",
"authorized_official_first_name": "MARK",
"authorized_official_middle_name": "LEON",
"authorized_official_title_or_position": "EMPLOYEE DOCTOR",
"authorized_official_telephone_number": "502-589-1500",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "KY",
"license": "41088",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Mar 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.