NPIMap

Organization Active NPI

Eyecare Center Optometrist PSC

  • Optometrist
  • Irvine, KY
National Provider Identifier
1700072253
Registry record updated Nov 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1069DT Issued in KY
Legal business name
EYECARE CENTER OPTOMETRIST PSC
Practice address
4235 Richmond Rd
Irvine, KY 40336-7262
Phone
(606) 726-9321
Fax
(606) 726-0019
NPI assigned
Sep 19, 2007
Last updated
Nov 7, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2008

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

Authorized official

Name
Dr. William T Reynolds Jr., ODNPI 1174516298
Title
Owner
Phone
(859) 623-3358

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1069DT KY Primary

Addresses

Primary practice location

4235 Richmond Rd
Irvine, KY 40336-7262

Mailing address

1020 Gibson Bay Dr
Richmond, KY 40475-3448
Phone (859) 623-3358

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031107000014 KY Part B Supplier - Clinic/Group Practice 0143133058 Receives reassigned benefits from 8 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Beattyville, KY; Irvine, KY; Lexington, KY; MC Kee, KY; Richmond, KY

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226016000000",
    "number": "1700072253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 GIBSON BAY DR",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404753448",
            "telephone_number": "859-623-3358",
            "fax_number": "859-623-3358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4235 RICHMOND RD",
            "city": "IRVINE",
            "state": "KY",
            "postal_code": "403367262",
            "telephone_number": "606-726-9321",
            "fax_number": "606-726-0019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYECARE CENTER OPTOMETRIST PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-19",
        "last_updated": "2008-11-07",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "859-623-3358",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1069DT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2008; 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.