Individual provider Active NPI

Shila K Lampl, OD

  • Optometrist
  • Wahpeton, ND
National Provider Identifier
1487661351
Registry record updated Aug 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
616 Issued in ND
Practice address
275 11TH St S
Wahpeton, ND 58075-4655
Phone
(701) 642-2000
Fax
(701) 671-4106
NPI assigned
Aug 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 616 ND Primary

Addresses

Primary practice location

275 11TH St S
Wahpeton, ND 58075-4655

Mailing address

275 11TH St S
Wahpeton, ND 58075-4655
Phone (701) 642-2000

Other identifiers 11

IdentifierTypeStateIssuer
26450OtherNDNDBS #
45425OtherNDLHS #
2202982OtherNDMEDICA #
DA9051044587OtherNDPREFERRED ONE #
HP52854OtherNDHEALTHPARTNERS #
2374577OtherNDAMERICA'S PPO/ARAZ #
60618MedicaidND
111658400MedicaidND
008H3LAOtherNDMNBS #
137087OtherNDUCARE #
9203480MedicaidND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050914001361 ND Practitioner - Optometry 8325947740 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Innovis Health LLCGroup PAC ID 9931298155, 561 clinicians

Practice addresses (Care Compare)

3000 32ND Ave S
Fargo, ND 58103-6132
Phone (701) 364-8000

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2960WIMDClinical Psychologist
2920MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Innovis Health, LLC CurrentSince Jan 1, 2008 Accepting new patients
Innovis Health LLC Optometrist CurrentSince Jan 1, 2008 Accepting new patients

Locations

2400 St Francis Dr
Breckenridge, MN 56520
Phone (218) 643-0226

208 Oppegard Ave NW
Twin Valley, MN 56584
Phone (218) 584-5181

3000 32nd Ave S
Fargo, ND 58103
Phone (701) 364-3000

275 11th St S
Wahpeton, ND 58075
Phone (701) 642-2000

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313971200000",
    "number": "1487661351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 11TH ST S",
            "city": "WAHPETON",
            "state": "ND",
            "postal_code": "580754655",
            "telephone_number": "701-642-2000",
            "fax_number": "701-671-4106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 11TH ST S",
            "city": "WAHPETON",
            "state": "ND",
            "postal_code": "580754655",
            "telephone_number": "701-642-2000",
            "fax_number": "701-671-4106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMPL",
        "first_name": "SHILA",
        "middle_name": "K",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2011-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ND",
            "license": "616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NDBS #",
            "identifier": "26450",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LHS #",
            "identifier": "45425",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA #",
            "identifier": "2202982",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE #",
            "identifier": "DA9051044587",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS #",
            "identifier": "HP52854",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICA'S PPO/ARAZ #",
            "identifier": "2374577",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60618",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111658400",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MNBS #",
            "identifier": "008H3LA",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE #",
            "identifier": "137087",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9203480",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wahpeton, ND

Sources for this page

Verify at the official NPI Registry.