Hartzell Rupp Ophthalmology P.C.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

MD417246 Issued in PA

Legal business name

HARTZELL RUPP OPHTHALMOLOGY P.C.

Practice address

3 Baden Powell LN
Suite 4
Mechanicsburg, PA 17050-5270

Phone

(717) 766-1566

Fax

(717) 766-2604

NPI assigned

Nov 27, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Kathleen Nicole Rupp, M.D.NPI 1548355522

Title

Owner

Phone

(717) 766-1566

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 1

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

• Kathleen Nicole Rupp, MD

  • Ophthalmology Physician
  • Mechanicsburg, PA
  • NPI 1548355522
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1322352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322611200000",
    "number": "1336416940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 BADEN POWELL LN",
            "address_2": "SUITE 4",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170505270",
            "telephone_number": "717-766-1566",
            "fax_number": "717-766-2604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 BADEN POWELL LN",
            "address_2": "SUITE 4",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170505270",
            "telephone_number": "717-766-1566",
            "fax_number": "717-766-2604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARTZELL RUPP OPHTHALMOLOGY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-27",
        "last_updated": "2011-11-30",
        "status": "A",
        "authorized_official_last_name": "RUPP",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "717-766-1566",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": "MD417246",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "055419MZV",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1008425800001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmology Physician in Mechanicsburg, PA
• Providers in Mechanicsburg, PA by specialty
• Ophthalmology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.