Organization Active NPI

Precision Eye Care Professionals PLLC

  • Optometrist
  • Bowling Green, KY
National Provider Identifier
1831350164
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1314DT Issued in KY
Legal business name
PRECISION EYE CARE PROFESSIONALS PLLC
Practice address
2625 Nashville Rd Ste 101
Bowling Green, KY 42101-4098
Phone
(270) 781-3937
Fax
(270) 783-3435
NPI assigned
Jun 19, 2008
Last updated
Jun 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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

Authorized official

Name
Dr. Robert Burlien Duvall, O.D.NPI 1548312481
Title
Optometrist/Owner
Phone
(270) 781-3937

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1314DT KY Primary

Addresses

Primary practice location

2625 Nashville Rd Ste 101
Bowling Green, KY 42101-4098

Mailing address

760 Campbell LN
Suite 120
Bowling Green, KY 42104-1085
Phone (270) 781-3937

Other identifiers 1

IdentifierTypeStateIssuer
00800OtherKYGROUP MEDICARE PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081201000153 KY Part B Supplier - Clinic/Group Practice 2466512033 Receives reassigned benefits from 6 practitioners
Practice locations: Bowling Green, KY

National Provider Directory

National Provider Directory

Locations

2625 Nashville Rd
Ste 101
Bowling Green, KY 42101
Phone (270) 781-3937

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1213833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718841600000",
    "number": "1831350164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 CAMPBELL LN",
            "address_2": "SUITE 120",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421041085",
            "telephone_number": "270-781-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 NASHVILLE RD STE 101",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421014098",
            "telephone_number": "270-781-3937",
            "fax_number": "270-783-3435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRECISION EYE CARE PROFESSIONALS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-19",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A",
        "authorized_official_last_name": "DUVALL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "BURLIEN",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "270-781-3937",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1314DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE PTAN",
            "identifier": "00800",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.