Haley Nicole Rambo, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

046.011676 Issued in IL

Practice address

1103 W Main St
Salem, IL 62881-1307

Phone

(618) 548-0100

NPI assigned

Aug 12, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Marion Eye Centers LTD.

  • Ophthalmology Physician
  • Marion, IL
  • NPI 1508865643

  Optometrist

  Medicare reassignment NPD
• Paul B Stauder

  • Optometrist
  • Fairfield, IL
  • NPI 1750479457
  Medicare reassignment
• Marion Eye Centers LTD.

  • Durable Medical Equipment & Medical Supplies
  • Sparta, IL
  • NPI 1982894465

  Optometrist

  NPD
• Talley Medical-Surgical Eye Care Associates PC

  • Ophthalmology Physician
  • Evansville, IN
  • NPI 1154319143

  Optometrist

  NPD

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

{
    "created_epoch": "1660262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1720716186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W DEYOUNG ST",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629594437",
            "telephone_number": "618-993-5686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 W MAIN ST",
            "city": "SALEM",
            "state": "IL",
            "postal_code": "628811307",
            "telephone_number": "618-548-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMBO",
        "first_name": "HALEY",
        "middle_name": "NICOLE",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-12",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.011676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Penta Group Inc.
• Penta Nascent Corporation
• Physician Services Corp of Southern Illinois
• Erik B Pikas, M.D.
• Mary K Piper, FNP
• Josee Redpath, OTR
• Revival Health and Wellness Clinic
• Jaime Renee Richardson, CPM
• Julia Roberts, FNP-C
• Elizabeth Marie Roedl, PHARMD

• Optometrist in Salem, IL
• Providers in Salem, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.