Individual provider Active NPI

Karen L Bouscher, O.D.

  • Optometrist
  • Wadsworth, OH
National Provider Identifier
1629083092
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4426/T1017 Issued in OH
Practice address
222 E Smokerise Dr
Walmart Vision Center
Wadsworth, OH 44281-8277
Phone
(330) 336-5301
Fax
(330) 336-5308
NPI assigned
Jul 31, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4426/T1017 OH Primary

Addresses

Primary practice location

222 E Smokerise Dr
Walmart Vision Center
Wadsworth, OH 44281-8277

Mailing address

222 E Smokerise Dr
Walmart Vision Center
Wadsworth, OH 44281-8277
Phone (330) 336-5301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20041001000245 OH Practitioner - Optometry 8224007885 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bouscher Family Eye Care IncGroup PAC ID 7315916970, 2 clinicians

Practice addresses (Care Compare)

222 E Smokerise Dr
Wadsworth, OH 44281-8277
Phone (330) 336-5301

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4426/T1017OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Bouscher Family Eye Care, Inc. Optometrist CurrentSince May 1, 2017 Accepting new patients
Wal-Mart Stores East, LP Past Accepting new patients

Locations

8160 Macedonia Commons Blvd
Macedonia, OH 44056
Phone (330) 468-0110

4572 Mega St NW
North Canton, OH 44720
Phone (330) 305-0037

222 E Smokerise Dr
Wadsworth, OH 44281
Phone (330) 336-5274

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, 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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629083092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 E SMOKERISE DR",
            "address_2": "WALMART VISION CENTER",
            "city": "WADSWORTH",
            "state": "OH",
            "postal_code": "442818277",
            "telephone_number": "330-336-5301",
            "fax_number": "330-336-5308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 E SMOKERISE DR",
            "address_2": "WALMART VISION CENTER",
            "city": "WADSWORTH",
            "state": "OH",
            "postal_code": "442818277",
            "telephone_number": "330-336-5301",
            "fax_number": "330-336-5308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUSCHER",
        "first_name": "KAREN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4426/T1017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wadsworth, OH

Sources for this page

Verify at the official NPI Registry.