Organization Active NPI

New Lexington Clinic, PSC

Doing business as Georgetown Optometric Center

  • Optometrist
  • Georgetown, KY
National Provider Identifier
1861687048
Registry record updated Aug 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
NEW LEXINGTON CLINIC, PSC
Doing business as
Georgetown Optometric Center
Practice address
1002 S Broadway St
Georgetown, KY 40324-1463
Phone
(502) 868-0422
Fax
(502) 867-1967
NPI assigned
Sep 11, 2007
Last updated
Aug 14, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
NEW LEXINGTON CLINIC, PSCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 14, 2008

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

Authorized official

Name
Randall Lemay
Title
Chief Financial Officer
Phone
(859) 258-4101

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X NU
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

1002 S Broadway St
Georgetown, KY 40324-1463

Mailing address

PO Box 11790
Lexington, KY 40578-1790
Phone (859) 258-6000

Other identifiers 1

IdentifierTypeStateIssuer
77902674MedicaidKY

Other names 1

  • Georgetown Optometric Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031121000103 KY Part B Supplier - Clinic/Group Practice 3476457532 Receives reassigned benefits from 397 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lexington, KY; Paris, KY; Mt Sterling, KY; Nicholasville, KY; Richmond, KY; Somerset, KY; Versailles, KY; Georgetown, KY…

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Keller and Jackson

NPI Registry JSON

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218672000000",
    "number": "1861687048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11790",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405781790",
            "telephone_number": "859-258-6000",
            "fax_number": "859-258-6123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 S BROADWAY ST",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403241463",
            "telephone_number": "502-868-0422",
            "fax_number": "502-867-1967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW LEXINGTON CLINIC, PSC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEW LEXINGTON CLINIC, PSC",
        "enumeration_date": "2007-09-11",
        "last_updated": "2008-08-14",
        "status": "A",
        "authorized_official_last_name": "LEMAY",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "859-258-4101"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77902674",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Georgetown Optometric Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Georgetown, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2008; 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.