Individual provider Active NPI

David M Eads, O.D.

  • Optometrist
  • Somerset, KY
National Provider Identifier
1811044951
Registry record updated Nov 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1063DT Issued in KY
Practice address
177 Washington Dr
Somerset, KY 42501-2938
Phone
(606) 679-0033
Fax
(606) 679-0152
NPI assigned
Jan 4, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1063DT KY Primary

Addresses

Primary practice location

177 Washington Dr
Somerset, KY 42501-2938

Mailing address

177 Washington Dr
Somerset, KY 42501-2938
Phone (606) 679-0033

Other identifiers 2

IdentifierTypeStateIssuer
77902203MedicaidKY
77010635MedicaidKY

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1063DTKYMDOptometrist
1063KYMDHearing Instrument Specialist

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385078400000",
    "number": "1811044951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177 WASHINGTON DR",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425012938",
            "telephone_number": "606-679-0033",
            "fax_number": "606-679-0152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 WASHINGTON DR",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425012938",
            "telephone_number": "606-679-0033",
            "fax_number": "606-679-0152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EADS",
        "first_name": "DAVID",
        "middle_name": "M",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2013-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1063DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77902203",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77010635",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2013; 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.