Individual provider Active NPI

Julie Lynn Guillaum, O.D.

  • Optometrist
  • Louisville, KY
National Provider Identifier
1669538450
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18002692 Issued in IN
Practice address
7101 Cedar Springs Blvd
Louisville, KY 40291-2587
Phone
(502) 231-7753
Fax
(502) 231-7054
NPI assigned
Dec 28, 2006
Sex
Female
Sole proprietor
Yes

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 18002692 IN Primary

Addresses

Primary practice location

7101 Cedar Springs Blvd
Louisville, KY 40291-2587

Mailing address

509 13TH Street
Tell City, IN 47586-1824
Phone (812) 547-5653

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18002692INMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Tavel of Evansville, LLC Optometrist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669538450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 13TH STREET",
            "city": "TELL CITY",
            "state": "IN",
            "postal_code": "475861824",
            "telephone_number": "812-547-5653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7101 CEDAR SPRINGS BLVD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402912587",
            "telephone_number": "502-231-7753",
            "fax_number": "502-231-7054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUILLAUM",
        "first_name": "JULIE",
        "middle_name": "LYNN",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.