Individual provider Active NPI

Caylen T Craft

  • Optometrist
  • Elizabethtown, KY
National Provider Identifier
1730539461
Registry record updated Jan 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2264DT Issued in KY
Practice address
1709 N Dixie Ave Ste 101
Elizabethtown, KY 42701-9456
Phone
(270) 765-2020
Fax
(502) 736-4482
NPI assigned
Jun 14, 2016
Last updated
Jan 26, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X ODT3416 TN
Optometrist 152W00000X 2264DT KY Primary

Addresses

Primary practice location

1709 N Dixie Ave Ste 101
Elizabethtown, KY 42701-9456

Mailing address

PO Box 207170
Dallas, TX 75320-7170
Phone (636) 200-4393

Other practice location 1

5323 Mount View Rd
Antioch, TN 37013-2308
Phone (270) 985-3369

Other practice location 2

325 W Walnut St
Lebanon, KY 40033-1377
Phone (270) 867-8200

Other practice location 3

544 Conestoga Pkwy Ste 17
Shepherdsville, KY 40165-5677
Phone (502) 955-2020

Other practice location 4

115 S 5th St
Bardstown, KY 40004-1108
Phone (502) 348-5125

Other practice location 5

10639 Dixie Hwy
Louisville, KY 40272-4349
Phone (502) 933-9200

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
I20220315000760 KY Practitioner - Optometry 4880979228 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clarkson Optometry Midwest IncGroup PAC ID 0749504165, 78 clinicians

Practice addresses (Care Compare)

1709 N Dixie Ave
Elizabethtown, KY 42701-9496
Phone (270) 765-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery26

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2264DTKYMDOptometrist
ODT3416TNMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Clarkson Optometry Midwest Inc Optometrist Current Accepting new patients
Clarkson Optometry Midwest Inc Optometrist CurrentSince Mar 1, 2022 Accepting new patients
Clarkson Optometry Midwest Inc Optometrist CurrentSince Mar 1, 2022 Accepting new patients
Clarkson Optometry Midwest Inc. Optometrist Past Accepting new patients
20-20 Eyecare PSC Optometrist Past Accepting new patients
C&V Opticals,Inc. PastSince Feb 1, 2021 Accepting new patients

Locations

115 S 5th St
Bardstown, KY 40004
Phone (502) 348-5125

3978 Alexandria Pike
Cold Spring, KY 41076
Phone (859) 441-8500

1709 N Dixie Ave
Elizabethtown, KY 42701
Phone (270) 765-2020

1709 N Dixie Ave
Ste 101
Elizabethtown, KY 42701
Phone (270) 765-2020

325 W Walnut St
Lebanon, KY 40033
Phone (270) 699-9500

10639 Dixie Hwy
Louisville, KY 40272
Phone (502) 231-2020

544 Conestoga Pkwy
Ste 17
Shepherdsville, KY 40165
Phone (502) 955-2020

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1465862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1730539461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 207170",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753207170",
            "telephone_number": "636-200-4393",
            "fax_number": "636-527-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1709 N DIXIE AVE STE 101",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427019456",
            "telephone_number": "270-765-2020",
            "fax_number": "502-736-4482"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5323 Mount View Rd",
            "address_purpose": "LOCATION",
            "city": "Antioch",
            "state": "TN",
            "postal_code": "370132308",
            "country_code": "US",
            "telephone_number": "270-985-3369",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "325 W Walnut St",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "KY",
            "postal_code": "400331377",
            "country_code": "US",
            "telephone_number": "270-867-8200",
            "fax_number": "502-916-3010",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "544 Conestoga Pkwy Ste 17",
            "address_purpose": "LOCATION",
            "city": "Shepherdsville",
            "state": "KY",
            "postal_code": "401655677",
            "country_code": "US",
            "telephone_number": "502-955-2020",
            "fax_number": "502-736-4488",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "115 S 5th St",
            "address_purpose": "LOCATION",
            "city": "Bardstown",
            "state": "KY",
            "postal_code": "400041108",
            "country_code": "US",
            "telephone_number": "502-348-5125",
            "fax_number": "502-348-2485",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10639 Dixie Hwy",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402724349",
            "country_code": "US",
            "telephone_number": "502-933-9200",
            "fax_number": "502-736-4487",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRAFT",
        "first_name": "CAYLEN",
        "middle_name": "T",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-14",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "ODT3416",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "2264DT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, KY

Sources for this page

Verify at the official NPI Registry.