RETINA AND VITREOUS ASSOCIATES OF KENTUCKY PSC (NPI# 1619949971) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619949971 |
| Entity Type | Organization |
| Organization Name | RETINA AND VITREOUS ASSOCIATES OF KENTUCKY PSC |
| Other Organization Name | LOW VISION SERVICES OF KY |
| Practice Address |
120 N Eagle Creek Dr Ste 500 Lexington KY 40509-1827 |
| Practice Telephone | 8592633900 |
| Practice Fax Number | 8592633757 |
| Mailing Telephone | 8592633900 |
| Mailing Fax Number | 8592633757 |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2020-07-21 |
| Authorized Official Name | WILLIAM WOOD (MD) |
| Authorized Official Telephone | 8592633900 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152WL0500X |
Optometrist Specialization: Low Vision Rehabilitation |
1689DT | KY | Eye and Vision Services Providers |
| N | 207W00000X | Ophthalmology | KY | Allopathic & Osteopathic Physicians | |
| Y | 207WX0107X |
Ophthalmology Specialization: Retina Specialist |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0730481 | 05 | |
| WV | 0007018000 | 05 | |
| KY | 65914236 | 05 | |
| IN | 201209490A | 05 |
| Other Name | Type Code |
|---|---|
| Low Vision Services of KY | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 120 N Eagle Creek Dr Ste 104, Lexington, KY 405091827 | 8592633900 | 8592633757 |
| 315 Leonardwood Rd Ste 4, Frankfort, KY 406016532 | 8592633900 | 8592633757 |
| 440 W Martin Luther King Blvd Ste 100, Danville, KY 404222037 | 8592633900 | 8592633757 |
| 311 N 3rd St, Bardstown, KY 400041507 | 8592633900 | 8592633757 |
| 23 Willow Dr, Auxier, KY 416029259 | 8592633900 | 8592633757 |
| 1700 Winchester Ave, Ashland, KY 411017649 | 8592633900 | 8592633757 |
| 2841 Lexington Ave, Ashland, KY 411013009 | 8592633900 | 8592633757 |
| 2353 Alexandria Dr Ste 210, Lexington, KY 405043287 | 8592633900 | 8592633757 |
| 1611 13th Ave, Huntington, WV 257013811 | 8592633900 | 8592633757 |
| 120 Tradepark Dr Ste A, Somerset, KY 425033454 | 8592633900 | 8592633757 |
| 189 Adam Shepherd Pkwy Ste 20, Shepherdsville, KY 401656579 | 8592633900 | 8592633757 |
| 13 Village Plz, Shelbyville, KY 400651745 | 8592633900 | 8592633757 |
| 238 Geri Ln Ste A, Richmond, KY 404752304 | 8592633900 | 8592633757 |
| 6420 Dutchmans Pkwy Ste 70, Louisville, KY 402053353 | 8592633900 | 8592633757 |
| 1406 W 5th St Ste 108, London, KY 407411688 | 8592633900 | 8592633757 |
| 5000 Ky Route 321, Prestonsburg, KY 416539113 | 8592633900 | 8592633757 |
| 3544 E 10th St, Jeffersonville, IN 471309315 | 8592633900 | 8592633757 |
| 120 N Eagle Creek Dr Ste 440, Lexington, KY 405091827 | 8592633900 | 8592633757 |
| Street Address |
120 N EAGLE CREEK DR STE 500 |
| City | LEXINGTON |
| State | KY |
| Zip Code | 40509-1827 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700881919 | Ricky D. Isernhagen | Ophthalmology | 120 N Eagle Creek Dr, Ste 500, Lexington, KY 40509-1827 | 2005-06-15 |
| 1992336036 | Lindsey Tong | Social Worker | 120 N Eagle Creek Dr, Lexington, KY 40509-1827 | 2020-01-28 |
| 1144710419 | Kaci M Wathen | Audiologist | 120 N Eagle Creek Dr, Lexington, KY 40509-1827 | 2018-05-13 |
| 1023427507 | Palak B Wall Md Pllc | Ophthalmology | 120 N Eagle Creek Dr, Lexington, KY 40509-1827 | 2014-08-08 |
| 1821424722 | Jessica M Bezner | Optometrist | 120 N Eagle Creek Dr, Ste 431, Lexington, KY 40509-1827 | 2013-09-24 |
| 1518222959 | Agata M Toborek | Pediatrics | 120 N Eagle Creek Dr, Ste 250, Lexington, KY 40509-1827 | 2012-07-11 |
| 1760747141 | Cgg Internal Medicine | Clinic/Center | 120 N Eagle Creek Dr, Suite321, Lexington, KY 40509-1827 | 2012-07-11 |
| 1023316890 | Lisa K Caldwell | Nurse Practitioner | 120 N Eagle Creek Dr, Ste 101, Lexington, KY 40509-1827 | 2011-03-03 |
| 1992008353 | Megan L Settles | Physician Assistant | 120 N Eagle Creek Dr, Suite 360, Lexington, KY 40509-1827 | 2010-12-07 |
| 1336469444 | Blake Isernhagen | Ophthalmology | 120 N Eagle Creek Dr, Ste 500, Lexington, KY 40509 | 2010-06-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902453640 | Grace T. Hallak | Counselor | 513 Darby Creek Rd, Lexington, KY 40509 | 2019-08-19 |
| 1932755774 | Lexington-fayette Urban-county Health Department | Public Health or Welfare | 4801 Athens Boonesboro Rd, Lexington, KY 40509 | 2019-08-16 |
| 1497308266 | Discover You Counseling LLC | Social Worker | 513 Darby Creek Drive, Unit 56 D, Lexington, KY 40509 | 2019-07-22 |
| 1407323611 | Trevor Douglas Mchardy | Physician Assistant | 101 North Eagle Creek Drive, Lexington, KY 40509 | 2018-10-25 |
| 1114413184 | Megan Medrano | Dietitian, Registered | 163 Old Todds Rd Ste 115, Lexington, KY 40509 | 2018-07-02 |
| 1750884292 | Active Medical LLC | Durable Medical Equipment & Medical Supplies | 3470 Blazer Pkwy Ste 350, Lexington, KY 40509 | 2018-03-12 |
| 1699273599 | Frederick Douglas High School | Public Health or Welfare | 2000 Winchester Rd, Lexington, KY 40509 | 2018-01-25 |
| 1710409370 | Sleep Identity Pllc | Clinic/Center | 541 Darby Creek Road, Ste 190, Lexington, KY 40509 | 2017-07-14 |
| 1164956397 | Danielle Anderson | Family Medicine | 24 Fountain Court, Suite 225, Lexington, KY 40509 | 2017-04-14 |
| 1356891782 | Dawn Jones | Physician Assistant | 101 N Eagle Creek Dr, Ste 120, Lexington, KY 40509 | 2016-10-10 |
| Find all providers in zip 40509 | ||||
| Taxonomy Code | 207WX0107X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| Specialization | Retina Specialist |
| An ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases. |
| Notes: Source: American Society of Retina Specialists, www.asrs.org [1/1/2017: new] - Additional Resources: American Academy of Ophthalmology, www.aao.org. Macula Society, www.maculasociety.org. Retina Society, www.retinasociety.org. Association of University Professors of Ophthalmology, www.aupo.org. |
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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.