Active NPI
Susan Rae Adams, LDO
- Optician
- Hanson, KY
National Provider Identifier
1134858467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 110284
- Practice address
- 420 Factory Outlet Dr
Hanson, KY 42413-9513 - Phone
- (270) 821-7177
- Fax
- (270) 322-8192
- NPI assigned
- Jun 10, 2022
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Optician | 156FX1800X | 110284 | KY | Primary |
Addresses
Primary practice location
420 Factory Outlet Dr
Hanson, KY 42413-9513
Mailing address
420 Factory Outlet Dr
Hanson, KY 42413-9513
Phone (270) 821-7177
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 110284 | KY | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654819200000",
"number": "1134858467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 FACTORY OUTLET DR",
"city": "HANSON",
"state": "KY",
"postal_code": "424139513",
"telephone_number": "270-821-7177",
"fax_number": "270-322-8192"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 FACTORY OUTLET DR",
"city": "HANSON",
"state": "KY",
"postal_code": "424139513",
"telephone_number": "270-821-7177",
"fax_number": "270-322-8192"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADAMS",
"first_name": "SUSAN",
"middle_name": "RAE",
"credential": "LDO",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-06-10",
"last_updated": "2022-06-10",
"certification_date": "2022-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "KY",
"license": "110284",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hanson, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.