Individual provider Active NPI

Johnny Richard Sproles

  • Optician
  • Middlesboro, KY
National Provider Identifier
1790415917
Registry record updated Jun 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
Practice address
1255 N 12TH St
Middlesboro, KY 40965-1896
Phone
(606) 248-5389
Fax
(606) 248-5289
NPI assigned
Jun 11, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X Primary

Addresses

Primary practice location

1255 N 12TH St
Middlesboro, KY 40965-1896

Mailing address

1255 N 12TH St Ste 1
Middlesboro, KY 40965-1838
Phone (606) 248-5389

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1654905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654905600000",
    "number": "1790415917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 N 12TH ST STE 1",
            "city": "MIDDLESBORO",
            "state": "KY",
            "postal_code": "409651838",
            "telephone_number": "606-248-5389",
            "fax_number": "606-248-5289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 N 12TH ST",
            "city": "MIDDLESBORO",
            "state": "KY",
            "postal_code": "409651896",
            "telephone_number": "606-248-5389",
            "fax_number": "606-248-5289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPROLES",
        "first_name": "JOHNNY",
        "middle_name": "RICHARD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-11",
        "last_updated": "2022-06-11",
        "certification_date": "2022-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middlesboro, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.