Active NPI
Shelley Clark Rachal, OD
- Vision Therapy Optometrist
- Niwot, CO
National Provider Identifier
1497371520
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vision Therapy Optometrist
- License
- 0003731
- Practice address
- 6800 N 79TH St Ste 101
Niwot, CO 80503-8978 - Phone
- (303) 652-0505
- NPI assigned
- Jun 24, 2020
- Last updated
- Oct 3, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vision Therapy Optometrist | 152WV0400X | 0003731 | CO | Primary |
Addresses
Primary practice location
6800 N 79TH St Ste 101
Niwot, CO 80503-8978
Mailing address
196 Maxwell Cir
Erie, CO 80516-8409
Phone (630) 532-4998
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0003731 | CO | MD | Vision Therapy Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Amy Chang OD PLLC | Optometrist | Current | Accepting new patients |
Locations
6800 N 79th St
Ste 101
Niwot, CO 80503
Phone (303) 652-0505
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696291200000",
"number": "1497371520",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "196 MAXWELL CIR",
"city": "ERIE",
"state": "CO",
"postal_code": "805168409",
"telephone_number": "630-532-4998"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6800 N 79TH ST STE 101",
"city": "NIWOT",
"state": "CO",
"postal_code": "805038978",
"telephone_number": "303-652-0505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RACHAL",
"first_name": "SHELLEY",
"middle_name": "CLARK",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-24",
"last_updated": "2023-10-03",
"certification_date": "2023-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "152WV0400X",
"taxonomy_group": "",
"desc": "Optometrist, Vision Therapy",
"state": "CO",
"license": "0003731",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Niwot, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.