Active NPI
Robert E Prouty, OD
- Optometrist
- Parker, CO
National Provider Identifier
1336120724
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1257
- Practice address
- 11960 Lioness Way
190
Parker, CO 80134-5640 - Phone
- (303) 794-1111
- Fax
- (303) 347-1341
- NPI assigned
- Nov 11, 2005
- Last updated
- Aug 28, 2015
- 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 | 1257 | CO | Primary |
Addresses
Primary practice location
11960 Lioness Way
190
Parker, CO 80134-5640
Mailing address
11960 Lioness Way
190
Parker, CO 80134-5640
Phone (303) 794-1111
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051117000406 | CO | Practitioner - Optometry | 2860411915 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1257 | CO | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131667200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440720000000",
"number": "1336120724",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11960 LIONESS WAY",
"address_2": "190",
"city": "PARKER",
"state": "CO",
"postal_code": "801345640",
"telephone_number": "303-794-1111",
"fax_number": "303-347-1341"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11960 LIONESS WAY",
"address_2": "190",
"city": "PARKER",
"state": "CO",
"postal_code": "801345640",
"telephone_number": "303-794-1111",
"fax_number": "303-347-1341"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROUTY",
"first_name": "ROBERT",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-11",
"last_updated": "2015-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CO",
"license": "1257",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Parker, CO
- Professional Dental Care of Central Colorado III PLLC (Soft Touch Dental)
- Professional Dental Care of New Mexico (Devine Dental of Las Vegas)
- Professional Dental Care of Northern Colorado I PLLC
- Professional Health Alliance (Parker Physical Therapy)
- Progressive Dental Health
- Rubaiat Akhter Punam
- Divinity M Purvey
- James Christopher Purviance, MFT
- Kristin Putnam, DO
- Elizabeth Jann Carlson Quaife, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.