MOUNTAIN OPTICAL, LLC (NPI# 1669661690) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669661690 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN OPTICAL, LLC |
| Practice Address |
2145 Us Highway 25 E Middlesboro KY 40965-1874 |
| Practice Telephone | 6062486030 |
| Practice Fax Number | 6062480014 |
| Mailing Telephone | 6062486030 |
| Mailing Fax Number | 6062480014 |
| Enumeration Date | 2007-10-16 |
| Last Update Date | 2015-09-02 |
| Authorized Official Name | KATHERINE SUE KECK (OWNER) |
| Authorized Official Telephone | 6062486030 |
| Authorized Official Credential | OPTICIAN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 156FX1800X |
Technician/Technologist Specialization: Optician |
Eye and Vision Services Providers | ||
| Y | 332H00000X | Eyewear Supplier (Equipment, not the service) | 0478 | KY | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | BCBS | 000000072724 | 01 |
| KY | EYEMED | KY0478 | 01 |
| KY | 52904786 | 05 |
| Street Address |
2145 US HIGHWAY 25 E |
| City | MIDDLESBORO |
| State | KY |
| Zip Code | 40965-1874 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841376480 | Lloyd Lee Cain Jr. | Optometrist | 2145 Us Highway 25 E, Middlesboro, KY 40965-1874 | 2006-10-27 |
| 1316488935 | Nicole Pursifull | Nurse Practitioner | 2145 Us Highway 25 E, Middlesboro, KY 40965-1874 | 2017-03-15 |
| 1144407370 | Lee Cain Od | Optometrist | 2145 Us Highway 25 E, Middlesboro, KY 40965-1874 | 2008-01-30 |
| 1568517852 | Katherine Sue Keck | Technician/Technologist | 2145 Us Highway 25 E, Middlesboro, KY 40965-1874 | 2007-01-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396387064 | Christopher Bruce Ellison | Social Worker | 809 19th Street, Middlesboro, KY 40965 | 2019-10-14 |
| 1982255030 | Johnny Wade Nantz II | Case Manager/Care Coordinator | 809 N 19th St, Middlesboro, KY 40965 | 2019-09-20 |
| 1558827774 | August Pediatrics, LLC | Pediatrics | 123 N 19th St Ste 302, Middlesboro, KY 40965 | 2019-02-12 |
| 1558843227 | Bethany Lauren Wade | Case Manager/Care Coordinator | 19th St, 809, Middlesboro, KY 40965 | 2018-08-30 |
| 1124521505 | Sonya Joyce Mcneil | Speech-Language Pathologist | Kidabilities Pediatric Therapy Center, 2801 Highway 25e, Suite 98, Middlesboro, KY 40965 | 2018-03-13 |
| 1518499862 | Vikki Lynn Johnson | Case Manager/Care Coordinator | 809 North 19th Street, Middlesboro, KY 40965 | 2017-03-28 |
| 1184164287 | Wilson Jeffrey | Occupational Therapist | Address: 235 New Wilson Lane, Middlesboro, KY 40965 | 2017-03-08 |
| 1447797444 | Lesha Loretta Williams | Physician Assistant | 2004 Cumberland Ave Ste 100, Middlesboro, KY 40965 | 2017-01-27 |
| 1619423910 | Audra Anissa Hall | Physical Therapist | 108 Turner Lane, Middlesboro, KY 40965 | 2016-08-28 |
| 1700332061 | Tammy Mclain | Counselor | Selfrefind 809 North 19th Street, Middlesboro, KY 40965 | 2016-08-28 |
| Find all providers in zip 40965 | ||||
| Taxonomy Code | 332H00000X |
| Grouping | Suppliers |
| Classification | Eyewear Supplier (Equipment, not the service) |
| An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215111612 | Todd Mcgeorge O.d. | Eyewear Supplier (Equipment, not the service) | 2131 Cumberland Ave, Middlesboro, KY 40965-2830 | 2007-12-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598399727 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 7900 Shelbyville Rd Ste B15, Louisville, KY 40222-5461 | 2020-02-26 |
| 1154961167 | Emx Eye Care PC | Eyewear Supplier (Equipment, not the service) | 410 Southtown Blvd Ste 4, Owensboro, KY 42303-7757 | 2020-01-08 |
| 1194215764 | Opticouture LLC | Eyewear Supplier (Equipment, not the service) | 959 Vine Street, Louisville, KY 40204-2071 | 2018-05-18 |
| 1477070654 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 111 Summit At Fritz Farm, Lexington, KY 40517-8300 | 2017-08-28 |
| 1568997112 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 3301 Nicholasville Rd, Lexington, KY 40503-3603 | 2017-04-20 |
| 1083160915 | Dr. Mark Lynn & Associates, Pllc | Eyewear Supplier (Equipment, not the service) | 7727 Mall Rd, Ste. B, Florence, KY 41042-1405 | 2016-08-31 |
| 1649626870 | Dr. Mark Lynn & Associates, Pllc | Eyewear Supplier (Equipment, not the service) | 2007 S Highway 27, Suite A, Somerset, KY 42501-0000 | 2016-05-06 |
| 1740644947 | Dr. Mark Lynn & Associates, Pllc | Eyewear Supplier (Equipment, not the service) | 450 Connector Rd, Georgetown, KY 40324-9729 | 2016-04-13 |
| 1477924884 | Dr Mark Lynn & Associates Pllc | Eyewear Supplier (Equipment, not the service) | 4135 Ft Campbell Boulevard, Hopkinsville, KY 42240-8706 | 2015-10-12 |
| 1245621382 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 1500 Fitzgerald Ct, Lexington, KY 40509-8307 | 2015-02-11 |
| Find all providers with the same taxonomy | ||||
| City | MIDDLESBORO |
| Zip Code | 40965 |
Please comment or provide details below to improve the information on MOUNTAIN OPTICAL, LLC.
| 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.