Organization Active NPI

Kevin Snipes OD & Associates PSC

  • Optometrist
  • Louisville, KY
National Provider Identifier
1821287335
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
KY1357DT Issued in KY
Legal business name
KEVIN SNIPES OD & ASSOCIATES PSC
Practice address
7900 Shelbyville Rd
Louisville, KY 40222-5451
Phone
(502) 327-8568
NPI assigned
Oct 21, 2007
Last updated
Nov 6, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2024

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

Authorized official

Name
Crystal Dawn Fuller
Title
Practice Administrator
Phone
(502) 536-0156

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X KY1357DT KY Primary

Addresses

Primary practice location

7900 Shelbyville Rd
Louisville, KY 40222-5451

Mailing address

7900 Shelbyville Rd Ste A15
Louisville, KY 40222-5463
Phone (502) 327-8568

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081218000089 KY Part B Supplier - Clinic/Group Practice 2163584624 Receives reassigned benefits from 16 practitioners
Practice locations: Lexington, KY; Louisville, KY

National Provider Directory

National Provider Directory
Tax ID family
Dr Kevin Snipes OD As2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

118 Marion
Ste 120
Lexington, KY 40517
Phone (859) 271-6194

2160 Sir Barton Way
Ste 143
Lexington, KY 40509
Phone (859) 543-0857

7900 Shelbyville Rd
Louisville, KY 40222
Phone (502) 327-8568

7900 Shelbyville Rd
Ste A15
Louisville, KY 40222
Phone (502) 327-8568

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1192924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730851200000",
    "number": "1821287335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7900 SHELBYVILLE RD STE A15",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402225463",
            "telephone_number": "502-327-8568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 SHELBYVILLE RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402225451",
            "telephone_number": "502-327-8568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN SNIPES OD & ASSOCIATES PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-21",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "502-536-0156"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "KY1357DT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Nov 6, 2024; 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.