NPIMap

Organization Active NPI

Guerrant Eye Clinic, PSC

  • Optometrist
  • Mt Sterling, KY
National Provider Identifier
1932379633
Registry record updated Feb 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
KY1214 Issued in KY
Legal business name
GUERRANT EYE CLINIC, PSC
Practice address
122 Stone Trace Drive
Suite a
Mount Sterling, KY 40353-5242
Phone
(888) 497-2117
Fax
(859) 497-2542
NPI assigned
Mar 10, 2008
Last updated
Feb 17, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2009

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

Authorized official

Name
Dr. Wallace Bullard Guerrant Jr., O.D.NPI 1982767364
Title
President and Ceo
Phone
(888) 497-2117

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X KY1214 KY Primary

Addresses

Primary practice location

122 Stone Trace Drive
Suite a
Mount Sterling, KY 40353-5242

Mailing address

122 Stone Trace Dr.
Suite a
Mt Sterling, KY 40353-5242
Phone (888) 497-2117

Other identifiers 1

IdentifierTypeStateIssuer
7100054840MedicaidKY

National Provider Directory

National Provider Directory

Locations

122 Stone Trace Dr
Ste A
Mt Sterling, KY 40353
Phone (859) 497-4444

122 Stone Trace Dr
Ste B
Mt Sterling, KY 40353
Phone (859) 497-2117

Practitioners & affiliated clinicians

Practitioners 3

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": "1205107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234828800000",
    "number": "1932379633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 STONE TRACE DR.",
            "address_2": "SUITE A",
            "city": "MT STERLING",
            "state": "KY",
            "postal_code": "403535242",
            "telephone_number": "888-497-2117",
            "fax_number": "859-497-2542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 STONE TRACE DRIVE",
            "address_2": "SUITE A",
            "city": "MOUNT STERLING",
            "state": "KY",
            "postal_code": "403535242",
            "telephone_number": "888-497-2117",
            "fax_number": "859-497-2542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUERRANT EYE CLINIC, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-10",
        "last_updated": "2009-02-17",
        "status": "A",
        "authorized_official_last_name": "GUERRANT",
        "authorized_official_first_name": "WALLACE",
        "authorized_official_middle_name": "BULLARD",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "888-497-2117",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "KY",
            "license": "KY1214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100054840",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Sterling, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.