NPIMap

Organization Active NPI

Lazenby Optometry Associates Inc

  • Optometrist
  • Joplin, MO
National Provider Identifier
1205048170
Registry record updated Jun 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TO2703 Issued in MO
Legal business name
LAZENBY OPTOMETRY ASSOCIATES INC
Practice address
2318 E. 32ND St.
Suite a
Joplin, MO 64804-4326
Phone
(417) 206-0399
Fax
(417) 206-0567
NPI assigned
May 4, 2007
Last updated
Jun 16, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2009

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

Authorized official

Name
Dr. Lorry Wayne Lazenby, O.D.NPI 1750489001
Title
Doctor
Phone
(417) 206-0399

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TO2703 MO Primary

Addresses

Primary practice location

2318 E. 32ND St.
Suite a
Joplin, MO 64804-4326

Mailing address

2318 E. 32ND St.
Ste a
Joplin, MO 64804-4326
Phone (417) 206-0399

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041115000842 MO Part B Supplier - Clinic/Group Practice 3274597760 Receives reassigned benefits from 3 practitioners
Practice locations: Joplin, MO

National Provider Directory

National Provider Directory

Locations

101 N Range Line Rd
Ste 342
Joplin, MO 64801
Phone (417) 782-9151

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245110400000",
    "number": "1205048170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2318 E. 32ND ST.",
            "address_2": "STE A",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648044326",
            "telephone_number": "417-206-0399",
            "fax_number": "417-206-0567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2318 E. 32ND ST.",
            "address_2": "SUITE A",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648044326",
            "telephone_number": "417-206-0399",
            "fax_number": "417-206-0567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAZENBY OPTOMETRY ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2009-06-16",
        "status": "A",
        "authorized_official_last_name": "LAZENBY",
        "authorized_official_first_name": "LORRY",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "417-206-0399",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "TO2703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.