Individual provider Active NPI

Mark Jeffery Fields, O.D.

  • Optometrist
  • Richmond, KY
National Provider Identifier
1720136351
Registry record updated Dec 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1315 DT Issued in KY
Practice address
820 Eastern Byp
Richmond, KY 40475-2512
Phone
(859) 625-0042
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1315 DT KY Primary

Addresses

Primary practice location

820 Eastern Byp
Richmond, KY 40475-2512

Mailing address

3704 Ridge View Way
Lexington, KY 40509-2941
Phone (859) 543-9474

Other identifiers 1

IdentifierTypeStateIssuer
77013159MedicaidKY

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
I20060207000035 KY Practitioner - Optometry 9638184021 Practice locations: Richmond, KY

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1995
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

820 Eastern by-Pass
Richmond, KY 40475-2912
Phone (859) 625-0042

820 Eastern Byp
Richmond, KY 40475-2512

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1315 DTKYMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197936000000",
    "number": "1720136351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3704 RIDGE VIEW WAY",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405092941",
            "telephone_number": "859-543-9474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 EASTERN BYP",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404752512",
            "telephone_number": "859-625-0042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIELDS",
        "first_name": "MARK",
        "middle_name": "JEFFERY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1315 DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77013159",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, KY

Sources for this page

Verify at the official NPI Registry.