Organization Active NPI

Shouse Optical Service Inc

  • Eyewear Supplier
  • Lexington, KY
National Provider Identifier
1457514838
Registry record updated Nov 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
SHOUSE OPTICAL SERVICE INC
Practice address
101 Malabu Dr # 7
Lexington, KY 40503-3141
Phone
(859) 276-1594
Fax
(859) 277-6421
NPI assigned
Jul 7, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2012

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

Authorized official

Name
John W Shouse
Title
Owner
Phone
(859) 276-1594

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

101 Malabu Dr # 7
Lexington, KY 40503-3141

Mailing address

101 Malabu Dr # 7
Lexington, KY 40503-3141
Phone (859) 276-1594

Other identifiers 1

IdentifierTypeStateIssuer
52902384MedicaidKY

Other names 1

  • John W Shouse Doing business as

National Provider Directory

National Provider Directory

Locations

101 Malabu Dr
Ste 78
Lexington, KY 40503
Phone (859) 276-1594

101 Malabu Dr
Ste 7
Lexington, KY 40503
Phone (859) 275-1212

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1215388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353283200000",
    "number": "1457514838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MALABU DR # 7",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405033141",
            "telephone_number": "859-276-1594",
            "fax_number": "859-277-6421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MALABU DR # 7",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405033141",
            "telephone_number": "859-276-1594",
            "fax_number": "859-277-6421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOUSE OPTICAL SERVICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-07",
        "last_updated": "2012-11-19",
        "status": "A",
        "authorized_official_last_name": "SHOUSE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "859-276-1594"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "52902384",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "John W Shouse",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2012; 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.