Individual provider Active NPI

Justin Eric Coleman, O.D.

  • Optometrist
  • Mount Sterling, KY
National Provider Identifier
1922440494
Registry record updated Aug 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1938DT Issued in KY
Practice address
25 Sterling Way
Ste C
Mount Sterling, KY 40353-1174
Phone
(859) 498-4800
Fax
(859) 498-2021
NPI assigned
Jul 24, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 1938DT KY
Optometrist 152W00000X 1938DT KY Primary

Addresses

Primary practice location

25 Sterling Way
Ste C
Mount Sterling, KY 40353-1174

Mailing address

25 Sterling Way
Ste C
Mount Sterling, KY 40353-1174
Phone (859) 498-4800

Other practice location 1

322 Kroger Ctr
Morehead, KY 40351-8895
Phone (859) 498-4800

Other identifiers 1

IdentifierTypeStateIssuer
7100261660MedicaidKY

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131001000148 KY Practitioner - Optometry 2860626058 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Nova Southeastern Univ College of Dental Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bluegrass Vision Group PLLCGroup PAC ID 8022385848, 4 clinicians
Bluegrass Vision Group of Hamburg PLLCGroup PAC ID 7113373598, 3 clinicians

Practice addresses (Care Compare)

25 Sterling Way
Suite C
Mount Sterling, KY 40353-1174
Phone (859) 498-4800

2716 Old Rosebud Rd
Suite 130
Lexington, KY 40509-8007
Phone (859) 327-3701

Hospital & facility affiliations

  • Saint Joseph Mount Sterling Hospital, Mount Sterling, KY, CCN 180064

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery24

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1938DTKYMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Bluegrass Vision Group of Morehead PLLC Optometrist CurrentSince Apr 16, 2019 Accepting new patients
Bluegrass Vision Group of Hamburg PLLC Optometrist CurrentSince Sep 12, 2023 Accepting new patients
KSM, PLLC Optometrist CurrentSince Sep 12, 2023 Accepting new patients
Bluegrass Vision Group PLLC Optometrist CurrentSince Aug 31, 2016 Accepting new patients

Locations

2716 Old Rosebud Rd
Ste 130
Lexington, KY 40509
Phone (859) 327-3701

322 Kroger Ctr
Morehead, KY 40351
Phone (606) 727-2800

25 Sterling Way
Ste C
Mt Sterling, KY 40353
Phone (859) 498-4800

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1374624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566518400000",
    "number": "1922440494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 STERLING WAY",
            "address_2": "STE C",
            "city": "MOUNT STERLING",
            "state": "KY",
            "postal_code": "403531174",
            "telephone_number": "859-498-4800",
            "fax_number": "859-498-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 STERLING WAY",
            "address_2": "STE C",
            "city": "MOUNT STERLING",
            "state": "KY",
            "postal_code": "403531174",
            "telephone_number": "859-498-4800",
            "fax_number": "859-498-2021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "322 Kroger Ctr",
            "address_purpose": "LOCATION",
            "city": "Morehead",
            "state": "KY",
            "postal_code": "403518895",
            "country_code": "US",
            "telephone_number": "859-498-4800",
            "fax_number": "859-498-2021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "JUSTIN",
        "middle_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-24",
        "last_updated": "2019-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "KY",
            "license": "1938DT",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1938DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100261660",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Sterling, KY

Sources for this page

Verify at the official NPI Registry.