Oak Tree Eye Clinic Inc PSC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

OAK TREE EYE CLINIC INC PSC

Practice address

1601 West Everly Brothers Blvd
Central City, KY 42330-0676

Phone

(270) 754-4515

Fax

(270) 754-2547

NPI assigned

Nov 1, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Freddie M Mayes

Title

President

Phone

(270) 754-4515

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 4

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

• Tyler Neal Mayes, OD

  • Optometrist
  • Central City, KY
  • NPI 1053609420
  Medicare reassignment Care Compare group NPD
• Haleigh Elizabeth Stringer Shipp, OD

  • Optometrist
  • Central City, KY
  • NPI 1063039451
  Medicare reassignment Care Compare group NPD
• Rachel M Hayden, OD

  • Optometrist
  • Henderson, KY
  • NPI 1144775008
  NPD (past)
• John Michael Soderling, OD

  • Optometrist
  • Greenville, KY
  • NPI 1225029556
  NPD (past)

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

{
    "created_epoch": "1130803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277424000000",
    "number": "1821089640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 WEST EVERLY BROTHERS BLVD",
            "city": "CENTRAL CITY",
            "state": "KY",
            "postal_code": "423300676",
            "telephone_number": "270-754-4515",
            "fax_number": "270-754-2547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 WEST EVERLY BROTHERS BLVD",
            "city": "CENTRAL CITY",
            "state": "KY",
            "postal_code": "423300676",
            "telephone_number": "270-754-4515",
            "fax_number": "270-754-2547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAK TREE EYE CLINIC INC PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-01",
        "last_updated": "2010-06-25",
        "status": "A",
        "authorized_official_last_name": "MAYES",
        "authorized_official_first_name": "FREDDIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "270-754-4515",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77903906",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Muhlenberg County Health Dept
• Muhlenberg County Health Dept
• Muhlenberg County Health Dept
• Jerry W Nein, MD
• Mandy N Newman, APRN
• Faith Oliver, PHARMD
• Lisa Marie Osborne
• Owensboro Health Medical Group Inc
• Owensboro Health Medical Group Inc
• Owensboro Health Medical Group Inc

• Optometrist in Central City, KY
• Providers in Central City, KY by specialty
• Optometrist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.