Organization Active NPI

Dr. Kenneth Lord, PC

  • Optometrist
  • Tucson, AZ
National Provider Identifier
1538488358
Registry record updated May 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0486 Issued in AZ
Legal business name
DR. KENNETH LORD, PC
Practice address
6987 N Oracle Rd
Tucson, AZ 85704-4224
Phone
(520) 297-2501
NPI assigned
May 18, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2010

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

Authorized official

Name
Stacia A Decker
Title
VP of Retail
Phone
(520) 327-6215

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 0486 AZ Primary

Addresses

Primary practice location

6987 N Oracle Rd
Tucson, AZ 85704-4224

Mailing address

6987 N Oracle Rd
Tucson, AZ 85704-4224
Phone (520) 297-2501

Other identifiers 1

IdentifierTypeStateIssuer
049777MedicaidAZ

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1274140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274140800000",
    "number": "1538488358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6987 N ORACLE RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857044224",
            "telephone_number": "520-297-2501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6987 N ORACLE RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857044224",
            "telephone_number": "520-297-2501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. KENNETH LORD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-18",
        "last_updated": "2010-05-18",
        "status": "A",
        "authorized_official_last_name": "DECKER",
        "authorized_official_first_name": "STACIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VP OF RETAIL",
        "authorized_official_telephone_number": "520-327-6215"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "0486",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "049777",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2010; 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.