Active NPI
Elena Lopez Hill, O.D.
- Optometrist
- Kennett, MO
National Provider Identifier
1003298928
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2017028246
- Practice address
- 1500 1St St
Kennett, MO 63857-2522 - Phone
- (573) 888-5331
- NPI assigned
- Jun 27, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2721 | AR | |
| Optometrist | 152W00000X | 2017028246 | MO | Primary |
Addresses
Primary practice location
1500 1St St
Kennett, MO 63857-2522
Mailing address
1500 1St St
Kennett, MO 63857-2522
Phone (573) 888-5331
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 210168722 | Medicaid | AR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2017028246 | MO | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635984000000",
"number": "1003298928",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 1ST ST",
"city": "KENNETT",
"state": "MO",
"postal_code": "638572522",
"telephone_number": "573-888-5331"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 1ST ST",
"city": "KENNETT",
"state": "MO",
"postal_code": "638572522",
"telephone_number": "573-888-5331"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HILL",
"first_name": "ELENA",
"middle_name": "LOPEZ",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-27",
"last_updated": "2021-11-04",
"certification_date": "2021-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "AR",
"license": "2721",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MO",
"license": "2017028246",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "210168722",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kennett, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.