Organization Active NPI

Helderman & Jacobs Vision Center, PLLC

  • Optometrist
  • Mount Sterling, KY
National Provider Identifier
1699824912
Registry record updated Jan 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
HELDERMAN & JACOBS VISION CENTER, PLLC
Practice address
1 N Maysville St
Mount Sterling, KY 40353-1315
Phone
(859) 498-6001
Fax
(859) 497-0222
NPI assigned
Jan 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2010

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

Authorized official

Name
Dr. Wayne A Helderman, OPTOMETRIST
Title
Partner Owner
Phone
(859) 498-6001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

1 N Maysville St
Mount Sterling, KY 40353-1315

Mailing address

1 N Maysville St
Mount Sterling, KY 40353-1315
Phone (859) 498-6001

Other identifiers 5

IdentifierTypeStateIssuer
000000382769OtherKYBCBS
77000461MedicaidKY
000000382771OtherKYBCBS
77903722MedicaidKY
77007623MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040629000790 KY Part B Supplier - Clinic/Group Practice 5193701159 Receives reassigned benefits from 2 practitioners
Practice locations: Mt Sterling, KY

National Provider Directory

National Provider Directory

Locations

1 N Maysville St
Mt Sterling, KY 40353
Phone (606) 663-9998

325 E College Ave
Stanton, KY 40380
Phone (606) 663-0950

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263859200000",
    "number": "1699824912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 N MAYSVILLE ST",
            "city": "MOUNT STERLING",
            "state": "KY",
            "postal_code": "403531315",
            "telephone_number": "859-498-6001",
            "fax_number": "859-497-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 N MAYSVILLE ST",
            "city": "MOUNT STERLING",
            "state": "KY",
            "postal_code": "403531315",
            "telephone_number": "859-498-6001",
            "fax_number": "859-497-0222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HELDERMAN & JACOBS VISION CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2010-01-19",
        "status": "A",
        "authorized_official_last_name": "HELDERMAN",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PARTNER OWNER",
        "authorized_official_telephone_number": "859-498-6001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OPTOMETRIST"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000382769",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77000461",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000382771",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77903722",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77007623",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Sterling, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.