Individual provider Active NPI

Abby J Schoonover, O.D.

  • Optometrist
  • Fort Collins, CO
National Provider Identifier
1053597112
Registry record updated Jul 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2607 Issued in CO
Practice address
2105 Bighorn Rd
Suite 104
Fort Collins, CO 80525-3555
Phone
(970) 377-0005
Fax
(970) 377-2520
NPI assigned
Jan 18, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2607 CO Primary

Addresses

Primary practice location

2105 Bighorn Rd
Suite 104
Fort Collins, CO 80525-3555

Mailing address

2105 Bighorn Rd
Suite 104
Fort Collins, CO 80525-3555
Phone (970) 377-0005

Other names 1

  • Abby J Outlaw Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080303000442 CO Practitioner - Optometry 2668556473 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rocky Mountain Family Vision, PCGroup PAC ID 9537206594, 4 clinicians

Practice addresses (Care Compare)

2105 Bighorn Rd
Suite 104
Fort Collins, CO 80525-3578

3609 S Timberline Rd
Unit B
Fort Collins, CO 80525-3430
Phone (970) 377-0005

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2607COMDOptometrist

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.

NPI Registry JSON

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

{
    "created_epoch": "1200614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311811200000",
    "number": "1053597112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 BIGHORN RD",
            "address_2": "SUITE 104",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805253555",
            "telephone_number": "970-377-0005",
            "fax_number": "970-377-2520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 BIGHORN RD",
            "address_2": "SUITE 104",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805253555",
            "telephone_number": "970-377-0005",
            "fax_number": "970-377-2520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHOONOVER",
        "first_name": "ABBY",
        "middle_name": "J",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-18",
        "last_updated": "2011-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ABBY",
            "last_name": "OUTLAW",
            "middle_name": "J",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.