James Maxwell Ernst, O.D.
Individual provider Active NPI Optometrist · Alexandria, KY
NPI 1689736506 · NPPES record last updated Nov 17, 2008
Key facts
- NPI
- 1689736506
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- KY1077DT (KY)
- Practice address
- 7517 Alexandria Pike
Alexandria, KY 41001-1051 - Phone
- (859) 635-7600
- Fax
- (859) 635-0900
- NPI assigned
- Dec 15, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| KY1077DT | KY | MD | Optometrist |
Interoperability endpoints
- james.ernst@direct.revolutionehr.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | KY1077DT | KY | Yes |
Addresses
Primary practice location
7517 Alexandria Pike
Alexandria, KY 41001-1051
Mailing address
7517 Alexandria Pike
Alexandria, KY 41001-1051
Phone (859) 635-7600
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 77010775 | Medicaid | KY |
Other providers in Alexandria, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 17, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.