Active NPI
Lauren E Hallum, OD
- Optometrist
- Lafayette, IN
National Provider Identifier
1790122489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 18003783
- Practice address
- 24 N Earl Ave
Lafayette, IN 47904-2813 - Phone
- (765) 447-0880
- Fax
- (765) 447-4789
- NPI assigned
- Jun 4, 2013
- Last updated
- Sep 9, 2014
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 18003783 | IN | Primary |
Addresses
Primary practice location
24 N Earl Ave
Lafayette, IN 47904-2813
Mailing address
9795 Crosspoint Blvd
Suite 100
Indianapolis, IN 46256-3354
Phone (317) 254-6480
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201164030 | Medicaid | IN |
Other names 1
- Miss Lauren E Walter
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
| License | State | Type | Specialty |
|---|---|---|---|
| 18003783 | IN | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eyecare Indiana | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1370304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410220800000",
"number": "1790122489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9795 CROSSPOINT BLVD",
"address_2": "SUITE 100",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462563354",
"telephone_number": "317-254-6480",
"fax_number": "317-259-8609"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24 N EARL AVE",
"city": "LAFAYETTE",
"state": "IN",
"postal_code": "479042813",
"telephone_number": "765-447-0880",
"fax_number": "765-447-4789"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALLUM",
"first_name": "LAUREN",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-06-04",
"last_updated": "2014-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IN",
"license": "18003783",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201164030",
"state": "IN"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LAUREN",
"last_name": "WALTER",
"middle_name": "E",
"prefix": "MISS",
"credential": "OD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Lafayette, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.