Individual provider Active NPI

Katelyn Bunn, OD

  • Optometrist
  • Springville, AL
National Provider Identifier
1760059018
Registry record updated Jun 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
S-E75 Issued in AL
Practice address
100 Legacy Park Way
Springville, AL 35146-1211
Phone
(205) 467-0308
NPI assigned
Jun 7, 2021
Last updated
Jun 7, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X S-E75 AL Primary

Addresses

Primary practice location

100 Legacy Park Way
Springville, AL 35146-1211

Mailing address

310 S 5TH St
Gadsden, AL 35901-4224
Phone (256) 547-8634

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20210806001400 AL Practitioner - Optometry 6608270087 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henagar Eye Clinic IncGroup PAC ID 7012070857, 2 clinicians
Gadsden Eye Associates P CGroup PAC ID 3779501523, 8 clinicians

Practice addresses (Care Compare)

17454 Alabama Hwy 75
P.O. Box 236
Henagar, AL 35978-5662
Phone (256) 899-3370

310 S 5TH St
Gadsden, AL 35901-4224
Phone (256) 547-8634

PO Box
Suite 236
Henagar, AL 35978-0236

Merit-based Incentive Payment System (MIPS)

Final score
84.81 of 100Reported as group
Quality
91.07
Improvement activities
40
Cost
61.28

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S-E75ALMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Gainesville Eye Associates LLC Optometrist Current Accepting new patients
Vision Alabama LLC Optometrist CurrentSince Aug 1, 2021 Accepting new patients
Gadsden Eye Associates P C Optometrist CurrentSince Aug 1, 2021 Accepting new patients

Locations

310 S 5th St
Gadsden, AL 35901
Phone (205) 547-8634

105 Ladiga St SE
Jacksonville, AL 36265
Phone (256) 547-8634

100 Legacy Park Way
Springville, AL 35146
Phone (205) 467-0308

500 Ross St
Pittsburgh, PA 15262
Phone (844) 362-6808

Interoperability endpoints

  • Direct secure messaging: kbunn@esp.intellechartdirect.net

Organizations & group practices 4

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": "1623024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1760059018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 S 5TH ST",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359014224",
            "telephone_number": "256-547-8634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 LEGACY PARK WAY",
            "city": "SPRINGVILLE",
            "state": "AL",
            "postal_code": "351461211",
            "telephone_number": "205-467-0308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNN",
        "first_name": "KATELYN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-07",
        "last_updated": "2021-06-07",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S-E75",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springville, AL

Sources for this page

Verify at the official NPI Registry.