Guadalupe Angelica Mejia Jr., O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1750DT Issued in KY

Practice address

301 E Muhammad Ali Blvd
Louisville, KY 40202-1511

Phone

(502) 852-5466

Fax

(502) 852-4947

NPI assigned

Jul 13, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1184284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319414400000",
    "number": "1508065020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 E BROADWAY STE 290",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402022040",
            "telephone_number": "502-217-8221",
            "fax_number": "502-217-5056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E MUHAMMAD ALI BLVD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021511",
            "telephone_number": "502-852-5466",
            "fax_number": "502-852-4947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEJIA",
        "first_name": "GUADALUPE",
        "middle_name": "ANGELICA",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-13",
        "last_updated": "2011-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "007185",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1750DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100114440",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meijer Great Lakes Limited Partnership
• Meijer Great Lakes Limited Partnership
• Meijer Great Lakes Limited Partnership
• Shawn Renee Meiman, APRN
• Joseph Francis Meiners, M.D.
• Magdalen K Mekoh, PMHNP-BC
• Melanie a Jarrell, LCSW,PLLC
• Melanie Drury Aprn LLC
• Christa Melcher
• Emily Christine Melcher

• Optometrist in Louisville, KY
• Providers in Louisville, KY by specialty
• Optometrist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2011; 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.