NPIMap

Organization Active NPI

Louisville Optometric Centers, III PSC

  • Eyewear Supplier
  • Hodgenville, KY
National Provider Identifier
1205906930
Registry record updated Feb 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
5419240003 Issued in KY
Legal business name
LOUISVILLE OPTOMETRIC CENTERS, III PSC
Practice address
109 S Walters Ave
Hodgenville, KY 42748-1533
Phone
(270) 358-8141
Fax
(270) 358-4556
NPI assigned
Nov 9, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Dr. Rod L. Rallo, O.D.NPI 1831181973
Title
Owner and Optometrist
Phone
(502) 459-2020

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

Other NPIs with the same Medicare PAC ID 18

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 18

Practitioners 38

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 38

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Vision First109 S Walters Ave, Hodgenville, KY 42748-1533(270) 358-8141 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Jan 1, 2005

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930028957 KY DME Supplier - Physician - Optometrist 8729041926 Practice locations: Hodgenville, KY

National Provider Directory

National Provider Directory
Tax ID family
Louisville Optometric I33 organizations share this tax ID, including this one

Other organizations with this tax ID 32

Organizations that report the same tax identification number in the National Provider Directory.

View all 32

Locations

109 S Walters Ave
Hodgenville, KY 42748
Phone (270) 358-4157

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X 5419240003 KY Primary

Addresses

NPPES NPI Registry

Primary practice location

109 S Walters Ave
Hodgenville, KY 42748-1533

Mailing address

109 S Walters Ave
Hodgenville, KY 42748-1533
Phone (270) 358-8141

Other names 1

NPPES NPI Registry
  • VisionFirst Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 19, 2014.

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392768000000",
    "number": "1205906930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 S WALTERS AVE",
            "city": "HODGENVILLE",
            "state": "KY",
            "postal_code": "427481533",
            "telephone_number": "270-358-8141",
            "fax_number": "270-358-4556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 S WALTERS AVE",
            "city": "HODGENVILLE",
            "state": "KY",
            "postal_code": "427481533",
            "telephone_number": "270-358-8141",
            "fax_number": "270-358-4556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUISVILLE OPTOMETRIC CENTERS, III PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2014-02-19",
        "status": "A",
        "authorized_official_last_name": "RALLO",
        "authorized_official_first_name": "ROD",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER AND OPTOMETRIST",
        "authorized_official_telephone_number": "502-459-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "KY",
            "license": "5419240003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VisionFirst",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hodgenville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.