NPIMap

Organization Active NPI

Ky Doctors of Optometry, PLLC

Doing business as KY Doctors of Optometry

  • Eyewear Supplier
  • Georgetown, KY
National Provider Identifier
1740644947
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
KY DOCTORS OF OPTOMETRY, PLLC
Doing business as
KY Doctors of Optometry
Visionworks Doctors of Optometry
Practice address
450 Connector Rd
Georgetown, KY 40324-9729
Phone
(502) 868-9870
Fax
(502) 868-5432
NPI assigned
Apr 13, 2016
Last updated
May 6, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2024

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

Authorized official

Name
Grant Rubesh
Title
Owner
Phone
(726) 444-4078

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

450 Connector Rd
Georgetown, KY 40324-9729

Mailing address

175 E Houston St
San Antonio, TX 78205-2255
Phone (726) 444-4069

Other names 2

  • KY Doctors of Optometry Doing business as
  • Visionworks Doctors of Optometry Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170109002327 KY DME Supplier - Physician - Optometrist 0941108732 Practice locations: Georgetown, KY

Other NPIs with the same Medicare PAC ID 22

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 22

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Ky Doctors of Optometry PLLC450 Connector Rd, Georgetown, KY 40324-9729(502) 868-9870 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Oct 1, 1998

National Provider Directory

National Provider Directory
Tax ID family
Doctors Valuvision22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

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

View all 21

Locations

500 Winchester Ave
Ste 180
Ashland, KY 41101

4655 Outer Loop
Louisville, KY 40219
Phone (502) 966-2020

2007 S Highway 27
Ste A
Somerset, KY 42501
Phone (606) 678-9953

Practitioners & affiliated clinicians

Practitioners 8

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": "1460505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714953600000",
    "number": "1740644947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 E HOUSTON ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782052255",
            "telephone_number": "726-444-4069",
            "fax_number": "210-524-6587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 CONNECTOR RD",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403249729",
            "telephone_number": "502-868-9870",
            "fax_number": "502-868-5432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KY DOCTORS OF OPTOMETRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-13",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A",
        "authorized_official_last_name": "RUBESH",
        "authorized_official_first_name": "GRANT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "726-444-4078"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KY Doctors of Optometry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Visionworks Doctors of Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Georgetown, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.