Individual provider Active NPI

Stephen Leroy Lauritsen, O.D.

  • Optometrist
  • Falmouth, ME
National Provider Identifier
1396047346
Registry record updated Nov 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT782 Issued in ME
Practice address
204 US Route 1
Carriage House Square
Falmouth, ME 04105-1342
Phone
(207) 781-7277
Fax
(207) 781-7277
NPI assigned
Nov 24, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT782 ME Primary

Addresses

Primary practice location

204 US Route 1
Carriage House Square
Falmouth, ME 04105-1342

Mailing address

204 US Route 1
Carriage House Square
Falmouth, ME 04105-1342
Phone (207) 781-7277

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

LicenseStateTypeSpecialty
OPT782MEMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1290556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290556800000",
    "number": "1396047346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 US ROUTE 1",
            "address_2": "CARRIAGE HOUSE SQUARE",
            "city": "FALMOUTH",
            "state": "ME",
            "postal_code": "041051342",
            "telephone_number": "207-781-7277",
            "fax_number": "207-781-7277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 US ROUTE 1",
            "address_2": "CARRIAGE HOUSE SQUARE",
            "city": "FALMOUTH",
            "state": "ME",
            "postal_code": "041051342",
            "telephone_number": "207-781-7277",
            "fax_number": "207-781-7277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAURITSEN",
        "first_name": "STEPHEN",
        "middle_name": "LEROY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-24",
        "last_updated": "2010-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ME",
            "license": "OPT782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Falmouth, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2010; 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.