Active NPI
Mary Anne Belcher, O.D,
- Optometrist
- Elkhorn City, KY
National Provider Identifier
1770633018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1059DT
- Practice address
- 20 Spring Ave
Elkhorn City, KY 41522 - Phone
- (606) 754-5775
- Fax
- (606) 754-5775
- NPI assigned
- Jan 11, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1059DT | KY | Primary |
Addresses
Primary practice location
20 Spring Ave
Elkhorn City, KY 41522
Mailing address
PO Box 1237
Elkhorn City, KY 41522-1237
Phone (606) 754-5775
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000185534 | Other | KY | ANTHEM BC BS |
| 410046162 | Other | KY | PALMETTO/ RR MEDICARE |
| 77010593 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1059DT | KY | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1425427200000",
"number": "1770633018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1237",
"city": "ELKHORN CITY",
"state": "KY",
"postal_code": "415221237",
"telephone_number": "606-754-5775",
"fax_number": "606-754-5775"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 SPRING AVE",
"city": "ELKHORN CITY",
"state": "KY",
"postal_code": "41522",
"telephone_number": "606-754-5775",
"fax_number": "606-754-5775"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BELCHER",
"first_name": "MARY",
"middle_name": "ANNE",
"credential": "O.D,",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-11",
"last_updated": "2015-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "KY",
"license": "1059DT",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BC BS",
"identifier": "000000185534",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PALMETTO/ RR MEDICARE",
"identifier": "410046162",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "77010593",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elkhorn City, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2015; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.