NPIMap

Organization Active NPI

University of Pikeville

Doing business as University of Pikeville Kentucky College of Optometry

  • Optometrist
  • Pikeville, KY
National Provider Identifier
1841657947
Registry record updated Jan 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1341 Issued in KY
Legal business name
UNIVERSITY OF PIKEVILLE
Doing business as
University of Pikeville Kentucky College of Optometry
Practice address
147 Sycamore St
Pikeville, KY 41501
Phone
(606) 218-5540
Fax
(606) 218-5509
NPI assigned
Jan 20, 2016
Last updated
Jan 29, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2019

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

Authorized official

Name
Dr. Cliff M Caudill, ODNPI 1841300712
Title
Assistant Dean for Clinical Affrair
Phone
(606) 218-5528

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 1341 KY Primary

Addresses

Primary practice location

147 Sycamore St
Pikeville, KY 41501

Mailing address

147 Sycamore St
Pikeville, KY 41501-9118
Phone (606) 218-5540

Other names 1

  • University of Pikeville Kentucky College of Optometry Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20181129001068 KY Part B Supplier - Clinic/Group Practice 6709120942 Receives reassigned benefits from 31 practitioners
Practice locations: Pikeville, KY; Martin, KY
O20191211002739 KY DME Supplier - Physician - OptometristDME Supplier - Optician 6709120942 Practice locations: Pikeville, KY

National Provider Directory

National Provider Directory
Tax ID family
University of Pikeville2 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

147 Sycamore St
Pikeville, KY 41501
Phone (606) 218-5250

147 Sycamore St
#858
Pikeville, KY 41501

8015 Millard Hwy
Ste 1
Pikeville, KY 41501
Phone (606) 240-2658

810 Hambley Blvd
Pikeville, KY 41501
Phone (606) 218-5354

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 32

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 32

NPI Registry JSON

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

{
    "created_epoch": "1453248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548720000000",
    "number": "1841657947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 SYCAMORE ST",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415019118",
            "telephone_number": "606-218-5540",
            "fax_number": "606-218-5509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 SYCAMORE ST",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "41501",
            "telephone_number": "606-218-5540",
            "fax_number": "606-218-5509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF PIKEVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-20",
        "last_updated": "2019-01-29",
        "status": "A",
        "authorized_official_last_name": "CAUDILL",
        "authorized_official_first_name": "CLIFF",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ASSISTANT DEAN FOR CLINICAL AFFRAIR",
        "authorized_official_telephone_number": "606-218-5528",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University of Pikeville Kentucky College of Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pikeville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2019; 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.