DR. JOHN P BRODERSON (NPI# 1558328286) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558328286 |
| Entity Type | Individual |
| Full Name | DR. JOHN P BRODERSON |
| Credential | M.D. |
| Practice Address |
102 Diagnostic Dr Frankfort KY 40601-6524 |
| Mailing Address |
Po Box 4265 Frankfort KY 40604-4265 |
| Practice Telephone | 5022238258 |
| Practice Fax Number | 5028759481 |
| Mailing Telephone | 5022238258 |
| Mailing Fax Number | 5028759481 |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | 15431 | KY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 64154313 | 05 | |
| KY | DEA REGISTRATION NUMBER | AB6788686 | 01 |
| Street Address |
102 DIAGNOSTIC DR |
| City | FRANKFORT |
| State | KY |
| Zip Code | 40601-6524 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215993274 | Robert George Kinker | Ophthalmology | 102 Diagnostic Dr, Frankfort, KY 40601 | 2006-04-26 |
| 1639365224 | Robert G. Kinker, Psc | Optometrist | 102 Diagnostic Dr, Frankfort, KY 40601-6524 | 2007-09-18 |
| 1073533865 | Eye Associates of Southern Indiana PC | Eyewear Supplier (Equipment, not the service) | 102 Diagnostic Dr, Frankfort, KY 40601-6524 | 2006-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568082410 | David Health Solutions | Nurse Practitioner | 796 Ninevah Rd, Frankfort, KY 40601 | 2020-04-21 |
| 1013549146 | Shawna Wallen | Pharmacist | 300 Brighton Park Blvd, Frankfort, KY 40601 | 2020-02-06 |
| 1629609417 | Suzannah Cartinhour Shouse | Pharmacist | 300 Brighton Park Blvd., Frankfort, KY 40601 | 2020-01-30 |
| 1942848460 | Prana Wellness | Occupational Therapist | 220 Conway Street, Frankfort, KY 40601 | 2019-12-16 |
| 1194288910 | Katherine Bates | Art Therapist | 2225 Lawrenceburg Road, Building A Suite 1, Frankfort, KY 40601 | 2019-04-09 |
| 1912476862 | Jennifer Suzann Robinson | Health Educator | 851 East-west Connector, Frankfort, KY 40601 | 2018-11-21 |
| 1649758541 | Parker Reynolds | Physical Therapist | 111 Westridge Drive, Suite E-f, Frankfort, KY 40601 | 2018-08-02 |
| 1376034397 | Bethany Ann Burton | Dentist | 1006 Leawood Dr Ste 200, Frankfort, KY 40601 | 2018-05-24 |
| 1174046106 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1303 Us Highway 127 S Ste 106, Frankfort, KY 40601 | 2017-07-21 |
| 1619498136 | Linda Carol Langley | Physical Therapist | 108 Diagnostic Dr., Suite C, Frankfort, KY 40601 | 2017-07-06 |
| Find all providers in zip 40601 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679039457 | Laser and Cataract Institute, LLC | Ophthalmology | 22200 Wolf Rd, Frankfort, IL 60423-7721 | 2019-02-15 |
| 1548389935 | Robert G Smith | Ophthalmology | 60 Devil Hollow Connector, Suite 200, Frankfort, KY 40601-2604 | 2007-03-28 |
| 1215993274 | Robert George Kinker | Ophthalmology | 102 Diagnostic Dr, Frankfort, KY 40601 | 2006-04-26 |
| 1043207228 | Irfan Ansari | Ophthalmology | 100 Diagnostic Dr, Frankfort, KY 40601-6524 | 2005-10-03 |
| 1841451192 | Whitson Vision, PC | Ophthalmology | 1258 Oak St, Suite B, Frankfort, IN 46041-3377 | 2008-06-19 |
| 1275790636 | Frankfort Eye Center Psc | Ophthalmology | 100 Diagnostic Dr, Frankfort, KY 40601-6524 | 2008-05-21 |
| 1033285960 | Quality Care for Kids | Ophthalmology | 100 Diagnostic Dr, Frankfort, KY 40601 | 2006-11-24 |
| 1194795435 | Randolph Lyons Offutt | Ophthalmology | 101 Medical Heights Dr, Suite B, Frankfort, KY 40601-4137 | 2006-01-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831722958 | Kentucky Eye Institue for Eye Health & Surgery | Ophthalmology | 130 Thompson Poynter Rd Ste 1, London, KY 40741-7280 | 2020-02-17 |
| 1558710970 | Christopher Areephanthu | Ophthalmology | 825 2nd Ave Ste A5, Bowling Green, KY 42101-1789 | 2016-06-07 |
| 1336503820 | Manan Raju Sampat | Ophthalmology | 1541 Lebanon Rd Ste 2, Danville, KY 40422-8349 | 2016-04-11 |
| 1588026181 | Michael S Tanner | Ophthalmology | 2720 Old Rosebud Rd Ste 110, Lexington, KY 40509-8005 | 2016-03-23 |
| 1528458023 | Senior Health Services LLC | Ophthalmology | 2410 Ring Rd, Suite 400, Elizabethtown, KY 42701-7994 | 2015-02-04 |
| 1447649827 | Senior Health Services LLC | Ophthalmology | 800 W Lincoln Trail Blvd, Suite 108, Radcliff, KY 40160-2671 | 2015-01-22 |
| 1477950269 | Tri-state Centers for Sight, Inc | Ophthalmology | 802 Scott St, Covington, KY 41011-2420 | 2014-11-24 |
| 1437554102 | Kyle M Ferguson | Ophthalmology | 1937 Old Main St Ste 1, Maysville, KY 41056-8956 | 2014-10-23 |
| 1609282375 | James Matthew Huffman | Ophthalmology | 120 N Eagle Creek Dr Ste 431, Lexington, KY 40509 | 2014-07-02 |
| 1588086508 | Lori Bettenhausen Williams | Ophthalmology | 1413 Evergreen Rd, Anchorage, KY 40223 | 2014-01-09 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.