NPIMap

Organization Active NPI

Myeyedr Optometry of Kentucky, PLLC

  • Optometrist
  • Louisville, KY
National Provider Identifier
1790409498
Registry record updated Sep 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MYEYEDR OPTOMETRY OF KENTUCKY, PLLC
Practice address
9501 Taylorsville Rd Ste 106
Louisville, KY 40299-2752
Phone
(502) 499-2020
Fax
(502) 499-6747
NPI assigned
Sep 27, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2022

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

Authorized official

Name
Sue Downes
Title
Secretary
Phone
(703) 847-8899

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

9501 Taylorsville Rd Ste 106
Louisville, KY 40299-2752

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

Other names 1

  • MyEyeDr Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190814002176 KY Part B Supplier - Clinic/Group Practice 1951638964 Receives reassigned benefits from 23 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Newport, KY; Louisville, KY; Lexington, KY; Cynthiana, KY; Crescent Springs, KY; Cold Spring, KY; Florence, KY

Other NPIs on the same Medicare enrollment 8

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

National Provider Directory

National Provider Directory
Tax ID family
Myeyedr Optometry of Kentucky PLLC10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1664236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664236800000",
    "number": "1790409498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9501 TAYLORSVILLE RD STE 106",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402992752",
            "telephone_number": "502-499-2020",
            "fax_number": "502-499-6747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYEYEDR OPTOMETRY OF KENTUCKY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-27",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A",
        "authorized_official_last_name": "DOWNES",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "703-847-8899"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MyEyeDr",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Sep 27, 2022; 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.