Organization Active NPI

Associates in Eye Care, Inc.

  • Optometrist
  • Albany, KY
National Provider Identifier
1720190101
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
ASSOCIATES IN EYE CARE, INC.
Practice address
127 Foothills Ave
Suite 3
Albany, KY 42602-1090
Phone
(606) 387-5612
Fax
(606) 387-6602
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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

Authorized official

Name
Gary Walter Upchurch, ODNPI 1265433478
Title
President and Authorized Official
Phone
(606) 387-5612

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 Primary

Addresses

Primary practice location

127 Foothills Ave
Suite 3
Albany, KY 42602-1090

Mailing address

PO Box 306
Ferguson, KY 42533-0306
Phone (606) 492-2211

Other identifiers 13

IdentifierTypeStateIssuer
0096603OtherKYMEDICARE # FOR DR. MARK JACOBS
39973; 4209301OtherTNBCBSTN/BLUECARE/TENNCARE
7100184290OtherKYMEDICAID # FOR DR. BENJAMIN BRENNER
77012011OtherKYMEDICAID # FOR DR. MARK JACOBS
46411OtherOPTUMHEALTH VISION
77900520MedicaidKY
CP0230:013OtherEYEMED
K009923OtherKYMEDICARE PTAN # FOR DR. BRENNER
77009298OtherKYMEDICAID # FOR DR. GARY UPCHURCH
CB8623OtherKYRAILROAD MEDICARE
0096602OtherLAMEDICARE # FOR DR. GARY UPCHURCH
1511738MedicaidTN
7100209970MedicaidKY

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL COMPULINK Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050513000284 KY Part B Supplier - Clinic/Group Practice 7012908643 Receives reassigned benefits from 10 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Albany, KY; Russell Springs, KY; Somerset, KY; Whitley City, KY; Williamsburg, 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

Locations

301 S Main St
Burkesville, KY 42717
Phone (270) 864-4315

880 Sparta Ct
Ste 100
Lexington, KY 40504

400 S Main St
London, KY 40741

1901 W Highway 90
Monticello, KY 42633
Phone (606) 348-6034

205 Bridge St
Munfordville, KY 42765
Phone (270) 524-7327

1930 Highway 90
Parkers Lake, KY 42634
Phone (606) 678-7664

39 Ferndale Apartments
#R
Pineville, KY 40977

116 Bayview Dr
Richmond, KY 40475
Phone (859) 575-4442

120 Tradepark Dr
Ste A
Somerset, KY 42503
Phone (606) 679-7778

235 S Richardson Dr
Somerset, KY 42501
Phone (513) 849-9331

144 Richie Ln
Somerset, KY 42503

758 Stockton Rd
Wallingford, KY 41093
Phone (606) 876-2167

Practitioners & affiliated clinicians

Practitioners 10

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": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616371200000",
    "number": "1720190101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 306",
            "city": "FERGUSON",
            "state": "KY",
            "postal_code": "425330306",
            "telephone_number": "606-492-2211",
            "fax_number": "606-676-0873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 FOOTHILLS AVE",
            "address_2": "SUITE 3",
            "city": "ALBANY",
            "state": "KY",
            "postal_code": "426021090",
            "telephone_number": "606-387-5612",
            "fax_number": "606-387-6602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATES IN EYE CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A",
        "authorized_official_last_name": "UPCHURCH",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "WALTER",
        "authorized_official_title_or_position": "PRESIDENT AND AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "606-387-5612",
        "authorized_official_credential": "OD"
    },
    "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": "MEDICARE # FOR DR. MARK JACOBS",
            "identifier": "0096603",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTN/BLUECARE/TENNCARE",
            "identifier": "39973; 4209301",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID # FOR DR. BENJAMIN BRENNER",
            "identifier": "7100184290",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID # FOR DR. MARK JACOBS",
            "identifier": "77012011",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTUMHEALTH VISION",
            "identifier": "46411",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77900520",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "CP0230:013",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN # FOR DR. BRENNER",
            "identifier": "K009923",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID # FOR DR. GARY UPCHURCH",
            "identifier": "77009298",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CB8623",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE # FOR DR. GARY UPCHURCH",
            "identifier": "0096602",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1511738",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100209970",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "COMPULINK",
            "affiliation": "N",
            "endpointDescription": "SECURE SOFTWARE",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "ELECTRONIC HEALTH RECORDS",
            "address_1": "127 Foothills Ave",
            "address_2": "Suite 3",
            "city": "Albany",
            "state": "KY",
            "country_code": "US",
            "postal_code": "426021090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Albany, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2021; 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.