Organization Active NPI

Mary Anne Belcher OD PSC

  • Optometrist
  • Elkhorn City, KY
National Provider Identifier
1730210287
Registry record updated Jan 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1059DT Issued in KY
Legal business name
MARY ANNE BELCHER OD PSC
Practice address
20 Spring Ave
Elkhorn City, KY 41522
Phone
(606) 754-5775
Fax
(606) 754-5775
NPI assigned
Mar 8, 2007
Last updated
Jan 11, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2010

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

Authorized official

Name
Mary Anne Belcher, ODNPI 1770633018
Title
OD
Phone
(606) 754-5775

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1059DT KY Primary

Addresses

Primary practice location

20 Spring Ave
Elkhorn City, KY 41522

Mailing address

PO Box 1237
Elkhorn City, KY 41522-1237
Phone (606) 754-5775

Other identifiers 2

IdentifierTypeStateIssuer
410046162OtherKYPALMETTO/ RR MEDICARE
77903433MedicaidKY

National Provider Directory

National Provider Directory

Locations

20 Spring Ave
Elkhorn City, KY 41522
Phone (606) 754-5775

Practitioners & affiliated clinicians

Practitioners 1

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": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263168000000",
    "number": "1730210287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1237",
            "city": "ELKHORN CITY",
            "state": "KY",
            "postal_code": "415221237",
            "telephone_number": "606-754-5775",
            "fax_number": "606-754-5775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 SPRING AVE",
            "city": "ELKHORN CITY",
            "state": "KY",
            "postal_code": "41522",
            "telephone_number": "606-754-5775",
            "fax_number": "606-754-5775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY ANNE BELCHER OD PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2010-01-11",
        "status": "A",
        "authorized_official_last_name": "BELCHER",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "OD",
        "authorized_official_telephone_number": "606-754-5775",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1059DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO/ RR MEDICARE",
            "identifier": "410046162",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77903433",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhorn City, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2010; 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.