Active NPI
Donald E Dlouhy, O.D.
- Optometrist
- Butler, WI
National Provider Identifier
1013060136
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1863-035
- Practice address
- 12728 W Hampton Ave
Butler, WI 53007-1602 - Phone
- (262) 781-8693
- Fax
- (262) 781-1468
- NPI assigned
- Jan 20, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1863-035 | WI | Primary |
Addresses
Primary practice location
12728 W Hampton Ave
Butler, WI 53007-1602
Mailing address
12728 W Hampton Ave
Butler, WI 53007-1602
Phone (262) 781-8693
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 391466974 | Other | WI | EYEMED |
| 915497 | Other | WI | VIPA |
| DE41133 | Other | WI | SPECTERA |
| 391466974 | Other | WI | NVA |
| 028578001 | Other | WI | NATIONAL SUPPLIER |
| 38519900 | Medicaid | WI | |
| 391466974 | Other | WI | VCP |
| 391466974 | Other | WI | VSP |
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)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1863-035 | WI | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1239753600000",
"number": "1013060136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12728 W HAMPTON AVE",
"city": "BUTLER",
"state": "WI",
"postal_code": "530071602",
"telephone_number": "262-781-8693",
"fax_number": "262-781-1468"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12728 W HAMPTON AVE",
"city": "BUTLER",
"state": "WI",
"postal_code": "530071602",
"telephone_number": "262-781-8693",
"fax_number": "262-781-1468"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DLOUHY",
"first_name": "DONALD",
"middle_name": "E",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-20",
"last_updated": "2009-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WI",
"license": "1863-035",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EYEMED",
"identifier": "391466974",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VIPA",
"identifier": "915497",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SPECTERA",
"identifier": "DE41133",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NVA",
"identifier": "391466974",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATIONAL SUPPLIER",
"identifier": "028578001",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "38519900",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VCP",
"identifier": "391466974",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VSP",
"identifier": "391466974",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Butler, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.