NPIMap

Organization Active NPI

Lodestar Family Eye Care, PC

  • Optometrist
  • Palmer, AK
National Provider Identifier
1659795797
Registry record updated Feb 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
295 Issued in AK
Legal business name
LODESTAR FAMILY EYE CARE, PC
Practice address
625 Cobb St, Ste 101
Palmer, AK 99645
Phone
(907) 745-2273
NPI assigned
Feb 10, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2014

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

Authorized official

Name
Dr. Kara Renee Reynolds, O.D.NPI 1134382419
Title
President
Phone
(907) 745-2273

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 298 AK
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 295 AK Primary

Addresses

Primary practice location

625 Cobb St, Ste 101
Palmer, AK 99645

Mailing address

625 Cobb Street, Suite 101
Palmer, AK 99645
Phone (907) 745-2273

Other identifiers 2

IdentifierTypeStateIssuer
OD0016MedicaidAK
OD0017MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140505001971 AK Part B Supplier - Clinic/Group Practice 5991938623 Receives reassigned benefits from 2 practitioners
Practice locations: Palmer, AK

National Provider Directory

National Provider Directory

Locations

625 S Cobb St
Ste 101
Palmer, AK 99645
Phone (907) 745-2273

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": "1391990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391990400000",
    "number": "1659795797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 COBB STREET, SUITE 101",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "99645",
            "telephone_number": "907-745-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 COBB ST, STE 101",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "99645",
            "telephone_number": "907-745-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LODESTAR FAMILY EYE CARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-10",
        "last_updated": "2014-02-10",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "KARA",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "907-745-2273",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "AK",
            "license": "298",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "AK",
            "license": "295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OD0016",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OD0017",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmer, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.