DR. THOMAS J KEENAN IV (NPI# 1083606123) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083606123 |
| Entity Type | Individual |
| Full Name | DR. THOMAS J KEENAN IV |
| Credential | OD |
| Practice Address |
1627 Midland Trl Shelbyville KY 40065-1638 |
| Practice Telephone | 5026332985 |
| Practice Fax Number | 5026470327 |
| Mailing Telephone | 5026332985 |
| Mailing Fax Number | 5026470327 |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2014-02-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 1008DT | KY | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 77010080 | 05 | |
| KY | RR MEDICARE | P00185446 | 01 |
| KY | ANTHEM BCBS | 000000350873 | 01 |
| KY | ANTHEM BCBS | 000000350897 | 01 |
| KY | OD LICENSE NUMBER | 1008DT | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285912402 | Thomas D Keenan | Dermatology | 1 S Park St, 7th Floor, Department of Dermatology,university of Wisconsin, Madison, WI 53715-0001 | 2011-07-22 |
| 1700809316 | Thomas J. Keenan | Internal Medicine | 946 Tuckertown Rd # F, Wakefield, RI 02879-2732 | 2006-07-25 |
| 1740563147 | Thomas Michael Keenan | Pharmacist | 21 Joyce St, Lynn, MA 01902-3636 | 2011-09-21 |
| 1164456307 | Thomas P Keenan | Ophthalmology | 302 S Cameron St, Winchester, VA 22601-4603 | 2006-07-11 |
| Street Address |
1627 MIDLAND TRL |
| City | SHELBYVILLE |
| State | KY |
| Zip Code | 40065-1638 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467946053 | Luke Moix | Optometrist | 1627 Midland Trl, Shelbyville, KY 40065 | 2018-06-18 |
| 1932361367 | Matthew L Dugger | Optometrist | 1627 Midland Trl, Shelbyville, KY 40065 | 2008-06-26 |
| 1578633210 | Louisville Optometric Centers, IIi Psc | Eyewear Supplier (Equipment, not the service) | 1627 Midland Trl, Shelbyville, KY 40065-1638 | 2006-11-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013348242 | Elisa Sykes-brees | Counselor | 250 Alpine Drive, Shelbyville, KY 40065 | 2013-12-13 |
| 1073800512 | Mimi Y. R. Rayburn | Nurse Practitioner | 865 Old Taylorsville Rd, Shelbyville, KY 40065 | 2011-07-05 |
| 1124310677 | Amanda B Dassel | Pharmacist | 1605 Midland Trail, Shelbyville, KY 40065 | 2011-05-03 |
| 1639468812 | Tia M Alton | Pediatrics | 150 Frankfort Rd Ste 101, Shelbyville, KY 40065 | 2011-03-29 |
| 1699073338 | Emily Ann Waits | Dietitian, Registered | 615 11th Street, Shelby County Health Dept., Shelbyville, KY 40065 | 2011-03-04 |
| 1124335401 | Kelli L. Fetter | Occupational Therapist | 1900 Midland Trail, Ste 1 & 2, Shelbyville, KY 40065 | 2010-09-08 |
| 1083939425 | Marilyn Louise Rhoads | Licensed Practical Nurse | 615 Washington Street, Mercy Clinic, Shelbyville, KY 40065 | 2010-03-29 |
| 1154525277 | Dorman Preschool Center | Early Intervention Provider Agency | 719 Burks Branch Road, Shelbyville, KY 40065 | 2007-06-13 |
| 1194946368 | Joanna Sames | Pharmacist | 16 Village Plaza, Shelbyville, KY 40065 | 2007-05-02 |
| 1033298922 | Robyn A Keeling | Dentist | 502 Mount Eden Rd, Shelbyville, KY 40065 | 2006-11-03 |
| Find all providers in zip 40065 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386113413 | Eye Care Center Associates Pa | Optometrist | 301 Colloredo Blvd Ste C, Shelbyville, TN 37160-2839 | 2018-11-19 |
| 1487005484 | Mid-state Eye Partners Inc | Optometrist | 102 N Heinlein Dr, Shelbyville, IL 62565-9050 | 2016-06-30 |
| 1639227697 | Louisville Optometric Centers, IIi Psc | Optometrist | 162 Midland Blvd, Shelbyville, KY 40065-9734 | 2007-01-08 |
| 1609950401 | Theodore E Bogart | Optometrist | West Route 16, Shelbyville, IL 62565-0199 | 2006-10-25 |
| 1952490336 | Gary A Borchert | Optometrist | 273 W Broadway St, Shelbyville, IN 46176-1101 | 2006-10-12 |
| 1881701720 | Robert Lynn Johnson | Optometrist | 919 Spring Hill Rd, Shelbyville, IN 46176-2759 | 2006-08-24 |
| 1508893348 | Kelly A Sanderson | Optometrist | 915 Colloredo Blvd, Shelbyville, TN 37160-2780 | 2006-06-27 |
| 1013972405 | Daniel Mark Bowersox | Optometrist | 403 Washington St, Shelbyville, KY 40065-1127 | 2006-04-19 |
| 1629050885 | Katherine Rebecca Garringer | Optometrist | 441 Amos Rd, Shelbyville, IN 46176-2245 | 2005-11-15 |
| 1619966728 | City Optical Co Inc | Optometrist | 1634 E State Rd 44, Shelbyville, IN 46614-1844 | 2005-10-20 |
| Find all providers in SHELBYVILLE | ||||
| City | SHELBYVILLE |
| Zip Code | 40065 |
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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.