NPIMap

Organization Active NPI

Mackey Vision Center PSC

  • Ophthalmology Physician
  • Corbin, KY
National Provider Identifier
1881877785
Registry record updated Apr 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
37261 Issued in KY
Legal business name
MACKEY VISION CENTER PSC
Practice address
281 N. Commonwealth Ave.
Corbin, KY 40702
Phone
(606) 528-1143
Fax
(606) 523-1145
NPI assigned
Dec 13, 2007
Last updated
Apr 8, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2009

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

Authorized official

Name
Dr. Benjamin L Mackey, M.D.NPI 1730181967
Title
President
Phone
(606) 528-1143

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU
Ophthalmology Physician 207W00000X 37261 KY Primary

Addresses

Primary practice location

281 N. Commonwealth Ave.
Corbin, KY 40702

Mailing address

PO Box 880
Corbin, KY 40702-0880

Other identifiers 2

IdentifierTypeStateIssuer
77007128MedicaidKY
64052327MedicaidKY

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050815000627 KY Part B Supplier - Clinic/Group Practice 0547290033 Receives reassigned benefits from 3 practitioners
Practice locations: Corbin, KY
O20100930064423 KY DME Supplier - Physician - OptometristDME Supplier - Optician 0547290033 Practice locations: Corbin, KY

National Provider Directory

National Provider Directory
Tax ID family
Robert E Mackey OD2 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.

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 4

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": "1197504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239148800000",
    "number": "1881877785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 880",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407020880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "281 N. COMMONWEALTH AVE.",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "40702",
            "telephone_number": "606-528-1143",
            "fax_number": "606-523-1145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACKEY VISION CENTER PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-13",
        "last_updated": "2009-04-08",
        "status": "A",
        "authorized_official_last_name": "MACKEY",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "606-528-1143",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "KY",
            "license": "37261",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77007128",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64052327",
            "state": "KY"
        }
    ],
    "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 Apr 8, 2009; 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.