Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Kevin Ryan Jackson, OD

Individual provider Optometrist · NPI 1588977508

Dr. Kevin Ryan Jackson, OD is an Optometry in Bowling Green, Kentucky. Graduated from Indiana University - School of Optometry in 2010, 16 years ago. Practices with Graves Gilbert Clinic PLLC, a 217-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Kentucky.

Years since qualifying
16
Trained at
Indiana University - School of Optometry
Licensed in
KY
In the registry since
2010
What do these letters mean?
OD — Doctor of Optometry
An optometrist: examines eyes, prescribes glasses and contacts, and treats many eye conditions.

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Practice location Address checks out

484 Golden Autumn Way Ste 201
Bowling Green, KY 42103-6914
Phone: (270) 780-2494
Fax: (270) 780-0465
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence 1814DT (KY)

Record details

NPI number1588977508
Entity typeIndividual (Type 1)
GenderMale
Credentials OD
Sole proprietorNo
NPI enumeratedJuly 19, 2010
Last updated in NPPESNovember 10, 2021
Certification dateNovember 10, 2021
Mailing address201 Park St, Bowling Green, KY 42101-1708

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOPTOMETRY
Medical schoolINDIANA UNIVERSITY - SCHOOL OF OPTOMETRY
Graduated 2010 (16 years in practice)
Group practice Graves Gilbert Clinic Pllc — 217 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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