Collaborative Care Medical Associates Inc.
NPI 1558690180ActiveOrganization· Optometrist· Hazard, KY
Optometrist in Hazard, Kentucky, registered in NPPES in December 2009. The authorized official on file is Dwight L. Avery, O.D., Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1558690180 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 10, 2009 |
| Last updated in NPPES | Jan 24, 2011 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Optometrist Primary | 152W00000X | 1120DT | KY |
| Nurse Practitioner | 363L00000X | 5556P | KY |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (KY) |
|---|
Other Optometrist providers in Hazard
- 1306573936
- 1396974077
- 1023892205
- 1265637565
- 1992883243
- 1245839000
- 1982592176
- 1356022966