Individual provider Active NPI

Richard Lazich, AU.D.

  • Audiologist
  • Louisville, KY
National Provider Identifier
1174683429
Registry record updated Mar 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
66 Issued in KY
Practice address
4135 Shelbyville Rd
Louisville, KY 40207-3203
Phone
(502) 890-3921
Fax
(502) 890-3923
NPI assigned
Dec 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 23002093A IN
Audiologist 231H00000X 66 KY Primary

Addresses

Primary practice location

4135 Shelbyville Rd
Louisville, KY 40207-3203

Mailing address

13403 Forest Springs Dr
Louisville, KY 40245-2077
Phone (502) 241-1350

Other identifiers 1

IdentifierTypeStateIssuer
200097020MedicaidIN

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
66KYMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Richard W. Lazich, Au.D. PLLC Audiologist CurrentSince Dec 28, 2008 Accepting new patients
Midwest Mobile Care Inc PastSince Sep 3, 2020 Accepting new patients
University Surgical Associates, PSC Audiologist Past Accepting new patients

Locations

4003 Kresge Way
Ste 227
Louisville, KY 40207
Phone (502) 281-0266

4135 Shelbyville Rd
Louisville, KY 40207
Phone (502) 883-2651

Organizations & group practices 3

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": "1165622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458950400000",
    "number": "1174683429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13403 FOREST SPRINGS DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402452077",
            "telephone_number": "502-241-1350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4135 SHELBYVILLE RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402073203",
            "telephone_number": "502-890-3921",
            "fax_number": "502-890-3923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZICH",
        "first_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-09",
        "last_updated": "2016-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IN",
            "license": "23002093A",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "KY",
            "license": "66",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200097020",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2016; 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.