NPIMap

Organization Active NPI

Kyle D. Andrus PC

  • Optometrist
  • St George, UT
National Provider Identifier
1053610956
Registry record updated May 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
KYLE D. ANDRUS PC
Practice address
1930 W. Sunset Blvd
Suite 106
St. George, UT 84770-6530
Phone
(435) 628-1112
Fax
(435) 628-5653
NPI assigned
Mar 18, 2011
Last updated
May 17, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2021

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

Authorized official

Name
Dr. Kyle D. Andrus, O.D.
Title
President
Phone
(435) 628-1112

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

1930 W. Sunset Blvd
Suite 106
St. George, UT 84770-6530

Mailing address

140 Flouroy Lucas Road
Shreveport, LA 71106
Phone (435) 229-1354

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1300406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621209600000",
    "number": "1053610956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 FLOUROY LUCAS ROAD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "71106",
            "telephone_number": "435-229-1354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 W. SUNSET BLVD",
            "address_2": "SUITE 106",
            "city": "ST. GEORGE",
            "state": "UT",
            "postal_code": "847706530",
            "telephone_number": "435-628-1112",
            "fax_number": "435-628-5653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KYLE D. ANDRUS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-18",
        "last_updated": "2021-05-17",
        "certification_date": "2021-04-24",
        "status": "A",
        "authorized_official_last_name": "ANDRUS",
        "authorized_official_first_name": "KYLE",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "435-628-1112",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 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.

Verify at the official NPI Registry.