Sage Peak Eye Care PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

SAGE PEAK EYE CARE PLLC

Practice address

1407 N Race St
Glasgow, KY 42141-3490

Phone

(270) 651-6652

NPI assigned

Dec 11, 2024

Organization subpart

No

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

Authorized official

Name

Shae Wilson, ODNPI 1972357382

Title

Owner

Phone

(270) 651-6652

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Locations

Practitioners 3

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

• Shae Wilson

  • Optometrist
  • Glasgow, KY
  • NPI 1972357382
  Medicare reassignment Care Compare group NPD Authorized official
• Darcy Minton Coomer, OD

  • Optometrist
  • Bowling Green, KY
  • NPI 1598779019
  Medicare reassignment Care Compare group NPD
• Stephen Douglas Ward, O.D.

  • Optometrist
  • Glasgow, KY
  • NPI 1083777429
  Medicare reassignment NPD

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

{
    "created_epoch": "1733875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733875200000",
    "number": "1922814243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1407 N RACE ST",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421413490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 N RACE ST",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421413490",
            "telephone_number": "270-651-6652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGE PEAK EYE CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-11",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-10",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "SHAE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-651-6652",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hillary Rush, M.S., CCC-SLP
• Amy Evans Rutledge, APRN
• Matthew E Rutter, M.D.
• Lucas Reed Ryan, MD
• Casey B Sacia, APRN
• Zakare Salifu, DO
• Emily Saltsman
• Tiffany Nicole Sanders
• Muralidhar R Santapuram, MD
• Michael A Saridakis, MD

• Optometrist in Glasgow, KY
• Providers in Glasgow, KY by specialty
• Optometrist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2024; 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.