NPIMap

Organization Active NPI

Louisville Optometric Centers, III PSC

  • Optometrist
  • Shelbyville, KY
National Provider Identifier
1639227697
Registry record updated Feb 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1008DT Issued in KY
Legal business name
LOUISVILLE OPTOMETRIC CENTERS, III PSC
Practice address
162 Midland Blvd
Shelbyville, KY 40065-9734
Phone
(502) 633-2985
Fax
(502) 647-0327
NPI assigned
Jan 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2014

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

Authorized official

Name
Dr. Rod L. Rallo, O.D.NPI 1831181973
Title
Owner
Phone
(502) 459-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1008DT KY Primary

Addresses

Primary practice location

162 Midland Blvd
Shelbyville, KY 40065-9734

Mailing address

4000 Poplar Level Rd
Louisville, KY 40213-1524
Phone (502) 459-2020

Other identifiers 1

IdentifierTypeStateIssuer
77903839MedicaidKY

Other names 1

  • VisionFirst Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Louisville Optometric I33 organizations share this tax ID, including this one

Other organizations with this tax ID 32

Organizations that report the same tax identification number in the National Provider Directory.

View all 32

Locations

162 Midland Blvd
Shelbyville, KY 40065
Phone (502) 633-2985

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392768000000",
    "number": "1639227697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 POPLAR LEVEL RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402131524",
            "telephone_number": "502-459-2020",
            "fax_number": "502-459-5925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 MIDLAND BLVD",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400659734",
            "telephone_number": "502-633-2985",
            "fax_number": "502-647-0327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUISVILLE OPTOMETRIC CENTERS, III PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2014-02-19",
        "status": "A",
        "authorized_official_last_name": "RALLO",
        "authorized_official_first_name": "ROD",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "502-459-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1008DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77903839",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VisionFirst",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shelbyville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2014; 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.