Premier Eye Care, PLLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

29402 Issued in KY

Legal business name

PREMIER EYE CARE, PLLC

Practice address

225 Hospital Dr Ste 160
Winchester, KY 40391-7635

Phone

(859) 744-3937

Fax

(859) 744-3941

NPI assigned

Oct 3, 2006

Organization subpart

Yes

Parent organization

PREMIER EYE CARE, PLLCAs reported in NPPES

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

Authorized official

Name

Mark Simon, MDNPI 1538110572

Title

Owner

Phone

(859) 744-3937

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Part of

Premier Eye Care PLLC

Locations

Practitioners 1

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

• Mark Simon, MD

  • Ophthalmology Physician
  • Winchester, KY
  • NPI 1538110572
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657497600000",
    "number": "1942394028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 HOSPITAL DR STE 160",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "403917635",
            "telephone_number": "859-744-3937",
            "fax_number": "859-744-3941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 HOSPITAL DR STE 160",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "403917635",
            "telephone_number": "859-744-3937",
            "fax_number": "859-744-3941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER EYE CARE, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PREMIER EYE CARE, PLLC",
        "enumeration_date": "2006-10-03",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A",
        "authorized_official_last_name": "SIMON",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "859-744-3937",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "KY",
            "license": "29402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65926727",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kendra Oliver Poe, LPCC
• Jennifer Ashley Pooler
• Positive Vibes Counseling, LLC
• Tena Hoffman Powe, DMD
• Mary Alice Prater, PT
• Regina Ann Prewitt, APRN
• Puckett Family Eye Care, PLLC
• Randall K Puckett
• Jacob Marshall Qualls, LCADC
• Stacey Rapier, LMT

• Ophthalmology Physician in Winchester, KY
• Providers in Winchester, KY by specialty
• Ophthalmology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2022; 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.