Individual provider Active NPI

Paul Louis Wright, MD

  • Ophthalmology Physician
  • Rapid City, SD
National Provider Identifier
1073550091
Registry record updated Jan 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
2216 Issued in SD
Practice address
240 Minnesota St
Rapid City, SD 57701-6200
Phone
(605) 718-5123
Fax
(605) 719-9509
NPI assigned
May 31, 2006
Last updated
Jan 20, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 2216 SD Primary

Addresses

Primary practice location

240 Minnesota St
Rapid City, SD 57701-6200

Mailing address

240 Minnesota St
Rapid City, SD 57701-6200
Phone (605) 718-5123

Other identifiers 2

IdentifierTypeStateIssuer
103216000MedicaidWY
6300173MedicaidSD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061120000412 SD Practitioner - Ophthalmology 8123026564

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295481600000",
    "number": "1073550091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 MINNESOTA ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577016200",
            "telephone_number": "605-718-5123",
            "fax_number": "605-719-9509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 MINNESOTA ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577016200",
            "telephone_number": "605-718-5123",
            "fax_number": "605-719-9509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "PAUL",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2011-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "SD",
            "license": "2216",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103216000",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6300173",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

Verify at the official NPI Registry.