Individual provider Active NPI

Laura Rush, O.D.

  • Optometrist
  • Idabel, OK
National Provider Identifier
1659795508
Registry record updated Feb 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1407 Issued in NE
Practice address
902 Lincoln Road
Idabel, OK 74745
Phone
(580) 286-2600
NPI assigned
Feb 13, 2014
Last updated
Feb 13, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1407 NE Primary

Addresses

Primary practice location

902 Lincoln Road
Idabel, OK 74745

Mailing address

240 Woodgrove St
Mesquite, TX 75181-3422
Phone (469) 767-7148

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20140410001462 TX Practitioner - Optometry 7214169960 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1407NEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince May 28, 2018 Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince May 28, 2018 Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital Current Accepting new patients

Locations

6 Road 7586
Bloomfield, NM 87413
Phone (505) 368-8015

Organizations & group practices 3

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": "1392249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392249600000",
    "number": "1659795508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 WOODGROVE ST",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751813422",
            "telephone_number": "469-767-7148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 LINCOLN ROAD",
            "city": "IDABEL",
            "state": "OK",
            "postal_code": "74745",
            "telephone_number": "580-286-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSH",
        "first_name": "LAURA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-13",
        "last_updated": "2014-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NE",
            "license": "1407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idabel, OK

Sources for this page

Verify at the official NPI Registry.