Organization Active NPI

Eye Centers of Southeast Kentucky PSC

  • Ophthalmology Physician
  • Corbin, KY
National Provider Identifier
1851400865
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
EYE CENTERS OF SOUTHEAST KENTUCKY PSC
Practice address
1490 Cumberland Falls Hwy
Corbin, KY 40701-2721
Phone
(606) 526-0433
Fax
(606) 526-0434
NPI assigned
Aug 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

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

Authorized official

Name
Dr. Stephen Trevor Briscoe, M.D.NPI 1679568661
Title
Provider, Owner
Phone
(606) 526-0433

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
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

1490 Cumberland Falls Hwy
Corbin, KY 40701-2721

Mailing address

1470 Cumberland Falls Hwy
Corbin, KY 40701
Phone (606) 526-0433

Other identifiers 1

IdentifierTypeStateIssuer
3725388MedicaidTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051102000742 KY Part B Supplier - Clinic/Group Practice 4587637061 Receives reassigned benefits from 1 practitioner
Practice locations: Corbin, KY; Harlan, KY; Pineville, KY

National Provider Directory

National Provider Directory

Locations

1490 Cumberland Falls Hwy
Corbin, KY 40701
Phone (606) 526-0433

1470 Cumberland Falls Hwy
Corbin, KY 40701
Phone (606) 526-0433

73 Eula Gray St
Ste 15
Harlan, KY 40831

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603843200000",
    "number": "1851400865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1470 CUMBERLAND FALLS HWY",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "40701",
            "telephone_number": "606-526-0433",
            "fax_number": "606-526-0434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1490 CUMBERLAND FALLS HWY",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407012721",
            "telephone_number": "606-526-0433",
            "fax_number": "606-526-0434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE CENTERS OF SOUTHEAST KENTUCKY PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A",
        "authorized_official_last_name": "BRISCOE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "TREVOR",
        "authorized_official_title_or_position": "PROVIDER, OWNER",
        "authorized_official_telephone_number": "606-526-0433",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3725388",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corbin, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; 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.