Active NPI
Jacqueline Marie Hallauer, OD
- Optometrist
- Huntington, WV
National Provider Identifier
1679000590
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2355DT
- Practice address
- 1540 Spring Valley Dr
Huntington, WV 25704-9501 - Phone
- (044) 296-7553
- NPI assigned
- May 23, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPT.006722 | OH | |
| Optometrist | 152W00000X | 2355DT | KY | Primary |
| Optometrist | 152W00000X | 4901005044 | MI |
Addresses
Primary practice location
1540 Spring Valley Dr
Huntington, WV 25704-9501
Mailing address
1540 Spring Valley Dr
Huntington, WV 25704-9501
Phone (044) 296-7553
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2355DT | KY | MD | Optometrist |
| 4901005044 | MI | MD | Optometrist |
| OPT.006722 | OH | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1495497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691625600000",
"number": "1679000590",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1540 SPRING VALLEY DR",
"city": "HUNTINGTON",
"state": "WV",
"postal_code": "257049501",
"telephone_number": "044-296-7553"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1540 SPRING VALLEY DR",
"city": "HUNTINGTON",
"state": "WV",
"postal_code": "257049501",
"telephone_number": "044-296-7553"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALLAUER",
"first_name": "JACQUELINE",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-05-23",
"last_updated": "2023-08-10",
"certification_date": "2023-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OH",
"license": "OPT.006722",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "KY",
"license": "2355DT",
"primary": true
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MI",
"license": "4901005044",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Huntington, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.