Organization Active NPI

Arthur a. Haley OD PSC

  • Eyewear Supplier
  • Campbellsville, KY
National Provider Identifier
1942409966
Registry record updated Oct 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
1181DT Issued in KY
Legal business name
ARTHUR A. HALEY OD PSC
Practice address
68 Wellness LN
Campbellsville, KY 42718-7650
Phone
(270) 469-4393
Fax
(270) 469-1050
NPI assigned
Jul 11, 2007
Last updated
Oct 30, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2025

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

Authorized official

Name
Arthur Andrew Haley, OD PSCNPI 1770589376
Title
Owner
Phone
(270) 469-4393

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
Eyewear Supplier 332H00000X 1181DT KY Primary

Addresses

Primary practice location

68 Wellness LN
Campbellsville, KY 42718-7650

Mailing address

68 Wellness LN
Campbellsville, KY 42718-7650
Phone (270) 469-4393

Other identifiers 1

IdentifierTypeStateIssuer
77011815MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040826000226 KY Part B Supplier - Clinic/Group Practice 6800860693 Receives reassigned benefits from 3 practitioners
Practice locations: Campbellsville, KY
O20100930042000 KY DME Supplier - Physician - OptometristDME Supplier - Optician 6800860693 Practice locations: Campbellsville, KY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Arthur a Haley OD PSC68 Wellness LN, Campbellsville, KY 42718-7650(270) 469-4393 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Does not accept assignmentParticipating since Apr 13, 2005

National Provider Directory

National Provider Directory

Locations

399 Campbellsville Byp
Ste 116
Campbellsvlle, KY 42718
Phone (270) 469-4393

68 Wellness Ln
Campbellsvlle, KY 42718
Phone (270) 469-4393

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": "1184112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761782400000",
    "number": "1942409966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 WELLNESS LN",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427187650",
            "telephone_number": "270-469-4393",
            "fax_number": "270-469-1050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 WELLNESS LN",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427187650",
            "telephone_number": "270-469-4393",
            "fax_number": "270-469-1050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARTHUR A. HALEY OD PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-11",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A",
        "authorized_official_last_name": "HALEY",
        "authorized_official_first_name": "ARTHUR",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-469-4393",
        "authorized_official_credential": "OD PSC"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "KY",
            "license": "1181DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77011815",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Campbellsville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.