Individual provider Active NPI

Laurie A Raab, OD

  • Optometrist
  • Weirton, WV
National Provider Identifier
1174637128
Registry record updated Nov 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
706-OD Issued in WV
Practice address
241 Three Springs Dr Ste 14
Weirton, WV 26062-3866
Phone
(304) 748-2055
Fax
(304) 748-2054
NPI assigned
Aug 18, 2006
Last updated
Nov 14, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 706-OD WV Primary
Optometrist 152W00000X OEG001174 PA

Addresses

Primary practice location

241 Three Springs Dr Ste 14
Weirton, WV 26062-3866

Mailing address

241 Three Springs Dr Ste 14
Weirton, WV 26062-3866
Phone (304) 748-2055

Other identifiers 1

IdentifierTypeStateIssuer
3810006166MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20100929001038 WV Practitioner - Optometry 9032235817 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

241 Three Springs Dr
Suite 14
Weirton, WV 26062-3865

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Michael P Kucher Optometrist PastSince Aug 15, 2010 Accepting new patients

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": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479081600000",
    "number": "1174637128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 THREE SPRINGS DR STE 14",
            "city": "WEIRTON",
            "state": "WV",
            "postal_code": "260623866",
            "telephone_number": "304-748-2055",
            "fax_number": "304-748-2054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 THREE SPRINGS DR STE 14",
            "city": "WEIRTON",
            "state": "WV",
            "postal_code": "260623866",
            "telephone_number": "304-748-2055",
            "fax_number": "304-748-2054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAAB",
        "first_name": "LAURIE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2016-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WV",
            "license": "706-OD",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG001174",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810006166",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Weirton, WV

Sources for this page

Verify at the official NPI Registry.