Robert Ratzlaff OD LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

474 Issued in NM

Legal business name

ROBERT RATZLAFF OD LLC

Practice address

1128-A Paseo del Pueblo Sur
7653 Ndcbu
Taos, NM 87571

Phone

(505) 758-3215

Fax

(505) 751-9280

NPI assigned

Nov 1, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Robert Ratzlaff, O.D.

Title

President/Manager

Phone

(505) 758-3215

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316024185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1128-A PASEO DEL PUEBLO SUR",
            "address_2": "7653 NDCBU",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "87571",
            "telephone_number": "505-758-3215",
            "fax_number": "505-751-9280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1128-A PASEO DEL PUEBLO SUR",
            "address_2": "7653 NDCBU",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "87571",
            "telephone_number": "505-758-3215",
            "fax_number": "505-751-9280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT RATZLAFF OD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RATZLAFF",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT/MANAGER",
        "authorized_official_telephone_number": "505-758-3215",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NM",
            "license": "474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "P7205",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Camille Rivera, ATC,LAT
• Kristen Danielle Rivera
• Michael H Rivera, D.D.S.
• Rachel Rivera, TEMPORARY LPCC
• Samantha A Rivera, CHW
• Gloria P Robertshaw, LISW
• Amber Robertson-Concha
• Rocky Mountain Clinics, LLC
• Rocky Mountain Holdings, LLC
• Rocky Mountainyouth Corps

• Optometrist in Taos, NM
• Providers in Taos, NM by specialty
• Optometrist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.