Mountain Optical, LLC

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

0478 Issued in KY

Legal business name

MOUNTAIN OPTICAL, LLC

Practice address

2145 US Highway 25 E
Middlesboro, KY 40965-1874

Phone

(606) 248-6030

Fax

(606) 248-0014

NPI assigned

Oct 16, 2007

Organization subpart

No

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

Authorized official

Name

Katherine Sue Keck, OPTICIAN

Title

Owner

Phone

(606) 248-6030

Specialties & licenses 2

Addresses

Other identifiers 3

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

{
    "created_epoch": "1192492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441152000000",
    "number": "1669661690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2145 US HIGHWAY 25 E",
            "city": "MIDDLESBORO",
            "state": "KY",
            "postal_code": "409651874",
            "telephone_number": "606-248-6030",
            "fax_number": "606-248-0014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2145 US HIGHWAY 25 E",
            "city": "MIDDLESBORO",
            "state": "KY",
            "postal_code": "409651874",
            "telephone_number": "606-248-6030",
            "fax_number": "606-248-0014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN OPTICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-16",
        "last_updated": "2015-09-02",
        "status": "A",
        "authorized_official_last_name": "KECK",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "606-248-6030",
        "authorized_official_credential": "OPTICIAN"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "KY",
            "license": "0478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000072724",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "52904786",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "KY0478",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chelsea Laine Monroe
• Charles A Moore, MD
• Mountain Comprehensive Health Corporation (Middlesboro Campus Clinic)
• Mountain Comprehensive Health Corporation (MCHC Middlesboro Pharmacy)
• Mountain Dental Care, PLLC
• Elizabeth Emily Mouser, MSW, CSW
• Sulabha S. Mujumdar, M.D.
• Mary Kaitlyn Murray
• Johnny Wade Nantz II
• Jennifer Napier

• Eyewear Supplier in Middlesboro, KY
• Providers in Middlesboro, KY by specialty
• Eyewear Supplier in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2015; 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.