NPIMap

Organization Active NPI

Kentucky Eye Care PSC

  • Ophthalmology Physician
  • Louisville, KY
National Provider Identifier
1760491328
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
KENTUCKY EYE CARE PSC
Practice address
6400 Dutchmans Pkwy
Ste 125
Louisville, KY 40205
Phone
(502) 896-8700
Fax
(502) 896-0813
NPI assigned
Aug 5, 2006
Last updated
Jan 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Authorized official

Name
Mark Aaron Ihnen, MDNPI 1770809212
Title
Physician
Phone
(502) 896-5750

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X NU
Optometrist 152W00000X NU
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

6400 Dutchmans Pkwy
Ste 125
Louisville, KY 40205

Mailing address

6400 Dutchmans Pkwy
Ste 125
Louisville, KY 40205
Phone (502) 896-8700

Other identifiers 1

IdentifierTypeStateIssuer
65918864MedicaidKY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930088950 KY DME Supplier - Physician - Ophthalmology 5092798389 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Louisville, KY

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

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": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705968000000",
    "number": "1760491328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 DUTCHMANS PKWY",
            "address_2": "STE 125",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40205",
            "telephone_number": "502-896-8700",
            "fax_number": "502-896-0813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 DUTCHMANS PKWY",
            "address_2": "STE 125",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40205",
            "telephone_number": "502-896-8700",
            "fax_number": "502-896-0813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENTUCKY EYE CARE PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A",
        "authorized_official_last_name": "IHNEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "AARON",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "502-896-5750",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65918864",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; 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.