Individual provider Active NPI

Lynne Louise Oliver, O.D.

  • Optometrist
  • Gilbert, AZ
National Provider Identifier
1740318302
Registry record updated Sep 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1404 Issued in AZ
Practice address
1400 N Gilbert Rd
Suite I
Gilbert, AZ 85234-2328
Phone
(480) 813-7050
NPI assigned
Mar 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1404 AZ Primary

Addresses

Primary practice location

1400 N Gilbert Rd
Suite I
Gilbert, AZ 85234-2328

Mailing address

1400 N Gilbert Rd
Suite I
Gilbert, AZ 85234-2328
Phone (480) 813-7050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20101117000701 AZ Practitioner - Optometry 0547455495 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1404AZMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Dao Inc Optometrist CurrentSince Jul 1, 2014 Accepting new patients
MVP.Vision Optometrist PastSince Dec 29, 2019 Accepting new patients

Locations

9265 E Baseline Rd
Ste 102
Mesa, AZ 85209
Phone (480) 354-4030

Organizations & group practices 2

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": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285718400000",
    "number": "1740318302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 N GILBERT RD",
            "address_2": "SUITE I",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342328",
            "telephone_number": "480-813-7050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N GILBERT RD",
            "address_2": "SUITE I",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342328",
            "telephone_number": "480-813-7050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "LYNNE",
        "middle_name": "LOUISE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-02",
        "last_updated": "2010-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "1404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.