Kevin D Stallard, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1349DT Issued in KY

Practice address

1303 Suite 108 US 127 South
Frankfort, KY 40601

Phone

(502) 875-3050

Fax

(502) 226-4261

NPI assigned

Aug 16, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

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

Specialty

Optometry

Education

Southern College of Optometry, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Louisville Optometric Centers III, PSCGroup PAC ID 8729041926, 38 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Louisville Optometric Centers III, PSC

  • Optometrist
  • Louisville, KY
  • NPI 1134111271

  KY, Optometrist

  Medicare reassignment Care Compare group NPD
• Louisville Optometric Centers III, PSC

  • Eyewear Supplier
  • Louisville, KY
  • NPI 1538938725
  NPD
• Louisville Optometric Centers, III PSC

  • Optometrist
  • Shelbyville, KY
  • NPI 1639227697
  NPD (past)

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392768000000",
    "number": "1770575805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 SUITE 108 US 127 SOUTH",
            "city": "FRANKFORT",
            "state": "KY",
            "postal_code": "40601",
            "telephone_number": "502-875-3050",
            "fax_number": "502-226-4261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 SUITE 108 US 127 SOUTH",
            "city": "FRANKFORT",
            "state": "KY",
            "postal_code": "40601",
            "telephone_number": "502-875-3050",
            "fax_number": "502-226-4261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALLARD",
        "first_name": "KEVIN",
        "middle_name": "D",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2014-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1349DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OD LICENSE NUMBER",
            "identifier": "1349DT",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77013498",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00293402",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000351950",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Ann Spath, M.D.
• Caroline R. Spencer, O.D.
• Emily C Spencer, PA-C
• Elizabeth Arlene Spradling
• Alexandra Marie Springhetti, MS, OTR/L
• Glenn William Stark, R.PH.
• David A Starkey, PHARM.D.
• Jill A Starzman, PT
• Anna Staton, APRN
• William Stauffer

• All providers in Frankfort, KY
• Optometrist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.