Active NPI
Teshawna Barker-Sutton, O.D.
- Optometrist
- London, KY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1541DT
- Practice address
- 930 E 4TH St
London, KY 40741-2521 - Phone
- (606) 878-7500
- Fax
- (606) 878-8005
- NPI assigned
- Aug 9, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1541DT | KY | Primary |
Addresses
Primary practice location
930 E 4TH St
London, KY 40741-2521
Mailing address
103 Chera Lynn St
London, KY 40741-3142
Phone (606) 878-7500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 77000834 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040630000682 | KY | Practitioner - Optometry | 9436136272 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1541DT | KY | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 20/20 Eyecare of London, LLC | Optometrist | Current | Accepting new patients |
| Henry Matt Magee OD, PSC | Optometrist | Past | Accepting new patients |
| Ulrich Medical Clinic, LLC | Past | Accepting new patients |
Locations
103 Chera Lynn St
London, KY 40741
Phone (606) 878-7500
677 Meyers Baker Rd
London, KY 40741
Phone (606) 878-7500
930 E 4th St
London, KY 40741
Phone (606) 878-7500
Ownership & related parties
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Health Express Family Practice and Urgent Care | Rural health clinic | 5% Or Greater Direct Ownership Interest (12.5%) | May 6, 2023 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Internal Medicine Physician
- London, KY
- NPI 1013951334
5% Or Greater Direct Ownership Interest
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Optometrist
- London, KY
- NPI 1780794321
-
- Family Medicine Physician
- East Bernstadt, KY
- NPI 1043339708
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- University Alabama Birmingham - School of Optometry, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- 20/20 Eyecare of London, LLC
Practice addresses (Care Compare)
103 Chera Lynn St
London, KY 40741-3142
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 36 |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1514419200000",
"number": "1891796314",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 CHERA LYNN ST",
"city": "LONDON",
"state": "KY",
"postal_code": "407413142",
"telephone_number": "606-878-7500",
"fax_number": "606-878-8005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "930 E 4TH ST",
"city": "LONDON",
"state": "KY",
"postal_code": "407412521",
"telephone_number": "606-878-7500",
"fax_number": "606-878-8005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARKER-SUTTON",
"first_name": "TESHAWNA",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-09",
"last_updated": "2017-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "KY",
"license": "1541DT",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "77000834",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in London, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.