Active NPI
John H Staub, OD
- Optometrist
- Carson City, NV
National Provider Identifier
1326154659
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 145
- Practice address
- 311 W Washington St
Ste B
Carson City, NV 89703 - Phone
- (775) 883-4664
- Fax
- (775) 883-4750
- NPI assigned
- Aug 21, 2006
- Last updated
- Feb 28, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 145 | NV | Primary |
Addresses
Primary practice location
311 W Washington St
Ste B
Carson City, NV 89703
Mailing address
311 W Washington St
Ste B
Carson City, NV 89703
Phone (775) 883-4664
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2513515 | Medicaid | NV |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 145 | NV | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ruckman Eyecare PC | Optometrist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204156800000",
"number": "1326154659",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "311 W WASHINGTON ST",
"address_2": "STE B",
"city": "CARSON CITY",
"state": "NV",
"postal_code": "89703",
"telephone_number": "775-883-4664",
"fax_number": "775-883-4750"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "311 W WASHINGTON ST",
"address_2": "STE B",
"city": "CARSON CITY",
"state": "NV",
"postal_code": "89703",
"telephone_number": "775-883-4664",
"fax_number": "775-883-4750"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAUB",
"first_name": "JOHN",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-21",
"last_updated": "2008-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NV",
"license": "145",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2513515",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Carson City, NV
- State of NV Aging & Disability Services Division- Assisted Living
- State of NV Aging & Disability Sevices Division- Fe Waiver
- State of NV Aging and Disability Services Division - Atap
- State of NV Aging and Disability Services Division - Atap
- State Public Charter School Authority
- Kimberly Marie Staugaard
- Keypher Steffanich, PA-C
- Rachel Ann Steigerwald, RN
- Stephen D Panter Crna LTD
- Stephen S Palazzolo
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 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.