Individual provider Active NPI

Karissa Paige Dyke

  • Optometrist
  • Benton, KY
National Provider Identifier
1689461667
Registry record updated Aug 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2457DT Issued in KY
Practice address
109 W 5TH St
Benton, KY 42025-1123
Phone
(270) 527-7421
NPI assigned
Apr 22, 2025
Last updated
Aug 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Optometrist 152W00000X 2457DT KY Primary

Addresses

Primary practice location

109 W 5TH St
Benton, KY 42025-1123

Mailing address

15933 Clayton Rd Ste 210
Ballwin, MO 63011-2172
Phone (636) 200-4393

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250822002401 KY Practitioner - Optometry 4183124241 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Kentucky School of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clarkson Optometry Midwest IncGroup PAC ID 0749504165, 78 clinicians

Practice addresses (Care Compare)

109 W 5TH St
Benton, KY 42025-1123
Phone (270) 527-7421

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Clarkson Optometry Midwest Inc Optometrist Current Accepting new patients
Clarkson Optometry Midwest Inc Optometrist CurrentSince Aug 8, 2025 Accepting new patients
Clarkson Optometry Midwest Inc Optometrist CurrentSince Aug 8, 2025 Accepting new patients
20-20 Eyecare PSC Optometrist Past Accepting new patients

Locations

109 W 5th St
Benton, KY 42025
Phone (270) 527-7421

43 Industrial Pkwy
Calvert City, KY 42029
Phone (270) 395-8331

3978 Alexandria Pike
Cold Spring, KY 41076
Phone (859) 441-8500

1400 Commonwealth Dr
Mayfield, KY 42066
Phone (270) 247-2417

817 N 12th St
Murray, KY 42071
Phone (270) 753-2842

1748 Broadway St
Paducah, KY 42001
Phone (270) 443-9955

Interoperability endpoints

  • Direct secure messaging: karissapdyke@direct.eyecare-partners.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1745280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754611200000",
    "number": "1689461667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15933 CLAYTON RD STE 210",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630112172",
            "telephone_number": "636-200-4393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 W 5TH ST",
            "city": "BENTON",
            "state": "KY",
            "postal_code": "420251123",
            "telephone_number": "270-527-7421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYKE",
        "first_name": "KARISSA",
        "middle_name": "PAIGE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-22",
        "last_updated": "2025-08-08",
        "certification_date": "2025-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "2457DT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Benton, KY

Sources for this page

Verify at the official NPI Registry.