Organization Active NPI

Kentucky Eye Care PSC

  • Ophthalmology Physician
  • Shelbyville, KY
National Provider Identifier
1710043393
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
KENTUCKY EYE CARE PSC
Practice address
13 Village PLZ
Shelbyville, KY 40065-1745
Phone
(502) 633-0829
Fax
(502) 633-0516
NPI assigned
Dec 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Authorized official

Name
Mark Aaron Ihnen, MD
Title
Physician
Phone
(502) 896-5750

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary
Eyewear Supplier 332H00000X

Addresses

Primary practice location

13 Village PLZ
Shelbyville, KY 40065-1745

Mailing address

13 Village PLZ
Shelbyville, KY 40065-1745
Phone (502) 633-0829

Other identifiers 1

IdentifierTypeStateIssuer
100023950AMedicaidIN

National Provider Directory

National Provider Directory
Tax ID family
Kentucky Eye Care PSC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705968000000",
    "number": "1710043393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 VILLAGE PLZ",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400651745",
            "telephone_number": "502-633-0829",
            "fax_number": "502-633-0516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 VILLAGE PLZ",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400651745",
            "telephone_number": "502-633-0829",
            "fax_number": "502-633-0516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENTUCKY EYE CARE PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A",
        "authorized_official_last_name": "IHNEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "AARON",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "502-896-5750",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100023950A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelbyville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; 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.