Active NPI
Randall G. Armstrong, O.D.
- Optometrist
- Monticello, IN
National Provider Identifier
1023087830
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 18001814
- Practice address
- 1173 W Broadway St
Monticello, IN 47960-1818 - Phone
- (574) 583-5531
- Fax
- (574) 583-4285
- NPI assigned
- Mar 15, 2006
- 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 | 18001814 | IN | Primary |
Addresses
Primary practice location
1173 W Broadway St
Monticello, IN 47960-1818
Mailing address
PO Box 383
Monticello, IN 47960-0383
Phone (574) 583-5531
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100088970B | Medicaid | IN | |
| 410037071 | Other | IN | RR MEDICARE ID# |
| 000000090677 | Other | IN | ANTHEM ID# |
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 |
|---|---|---|---|
| 18001814 | IN | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakeview Optometry PC | Optometrist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Optometrist
- Monticello, IN
- NPI 1740821438
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1215475200000",
"number": "1023087830",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 383",
"city": "MONTICELLO",
"state": "IN",
"postal_code": "479600383",
"telephone_number": "574-583-5531",
"fax_number": "574-583-4285"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1173 W BROADWAY ST",
"city": "MONTICELLO",
"state": "IN",
"postal_code": "479601818",
"telephone_number": "574-583-5531",
"fax_number": "574-583-4285"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ARMSTRONG",
"first_name": "RANDALL",
"middle_name": "G.",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-03-15",
"last_updated": "2008-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IN",
"license": "18001814",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100088970B",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE ID#",
"identifier": "410037071",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM ID#",
"identifier": "000000090677",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Monticello, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.