Ruidoso National Optical Center

Primary specialty

OptometristTaxonomy code 152W00000X

License

251 Issued in NM

Legal business name

RUIDOSO NATIONAL OPTICAL CENTER

Practice address

1800 Highway 70 West
Ruidoso Downs, NM 88346

Phone

(505) 255-9410

Fax

(505) 255-9875

NPI assigned

Jul 10, 2008

Last updated

Jul 10, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Bill G McDonald, O.D.

Title

Provider

Phone

(505) 378-7148

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215648000000",
    "number": "1316100225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 SAN MATEO BLVD SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871082919",
            "telephone_number": "505-378-7148",
            "fax_number": "505-378-1117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 HIGHWAY 70 WEST",
            "city": "RUIDOSO DOWNS",
            "state": "NM",
            "postal_code": "88346",
            "telephone_number": "505-255-9410",
            "fax_number": "505-255-9875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUIDOSO NATIONAL OPTICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-10",
        "last_updated": "2008-07-10",
        "status": "A",
        "authorized_official_last_name": "MCDONALD",
        "authorized_official_first_name": "BILL",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "505-378-7148",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NM",
            "license": "251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOCTOR INDIVIDUAL NPI",
            "identifier": "1134113541",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "48374016",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Richard Aaron Roberts, RPH
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• Optometrist in Ruidoso Downs, NM
• Providers in Ruidoso Downs, NM by specialty
• Optometrist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2008; 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.