Katrae MJ LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

299T Issued in WY

Legal business name

KATRAE MJ LLC

Practice address

1526 Centennial CT
Casper, WY 82609-7304

Phone

(307) 237-6025

Fax

(307) 337-3462

NPI assigned

Mar 9, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Levi M Porter, O.D.NPI 1417992553

Title

Optometrist

Phone

(503) 504-6941

Specialties & licenses 1

Addresses

Other names 1

• Wind City Eye Care Doing business as

Medicare fee-for-service enrollment

Enrolled in WY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Levi Marc Porter, O.D.

  • Optometrist
  • Eagle River, AK
  • NPI 1417992553

  Optometrist, WY

  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1489017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489017600000",
    "number": "1003357153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1526 CENTENNIAL CT",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826097304",
            "telephone_number": "307-237-6025",
            "fax_number": "307-337-3462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1526 CENTENNIAL CT",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826097304",
            "telephone_number": "307-237-6025",
            "fax_number": "307-337-3462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATRAE MJ LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-09",
        "last_updated": "2017-03-09",
        "status": "A",
        "authorized_official_last_name": "PORTER",
        "authorized_official_first_name": "LEVI",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "503-504-6941",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WY",
            "license": "299T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wind City Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Raegan Layher Kartupelis, PMHNP-BC
• Diane Kay Kasler, MS, CCC-SLP
• Abraham Kaslow, M.D.
• Susan Kates, MS, LMFT
• Nikita Katoozi, OD
• Kent Douglas Katz, MD
• Joshua James Kaufman, MA, LPC
• Benjamin C Kautza, M.D.
• Brett Kautzmann, PT, DPT
• Kaye Reed

• All providers in Casper, WY
• Optometrist in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.