Organization Active NPI

Losh Optometry LLC

  • Optometrist
  • Maryville, MO
National Provider Identifier
1487056560
Registry record updated Jan 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
LC1394389 Issued in MO
Legal business name
LOSH OPTOMETRY LLC
Practice address
109 S Buchanan St
Maryville, MO 64468-2384
Phone
(660) 241-5001
Fax
(660) 241-5004
NPI assigned
Sep 21, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2015

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

Authorized official

Name
Dr. Ryan K Losh, O.D.NPI 1821309600
Title
Member/Manager
Phone
(660) 241-5001

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X LC1394389 MO Primary

Addresses

Primary practice location

109 S Buchanan St
Maryville, MO 64468-2384

Mailing address

109 S Buchanan St
Maryville, MO 64468-2384
Phone (660) 241-5001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141117000560 MO Part B Supplier - Clinic/Group Practice 6305068925 Receives reassigned benefits from 1 practitioner
Practice locations: Maryville, MO

National Provider Directory

National Provider Directory

Locations

109 S Buchanan St
Maryville, MO 64468
Phone (660) 241-5001

Practitioners & affiliated clinicians

Practitioners 1

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": "1411257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422403200000",
    "number": "1487056560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 S BUCHANAN ST",
            "city": "MARYVILLE",
            "state": "MO",
            "postal_code": "644682384",
            "telephone_number": "660-241-5001",
            "fax_number": "660-241-5004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 S BUCHANAN ST",
            "city": "MARYVILLE",
            "state": "MO",
            "postal_code": "644682384",
            "telephone_number": "660-241-5001",
            "fax_number": "660-241-5004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOSH OPTOMETRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-21",
        "last_updated": "2015-01-28",
        "status": "A",
        "authorized_official_last_name": "LOSH",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MEMBER/MANAGER",
        "authorized_official_telephone_number": "660-241-5001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MO",
            "license": "LC1394389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.