Loudoun Eye Associates, PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618001310 Issued in VA

Legal business name

LOUDOUN EYE ASSOCIATES, PLLC

Practice address

43480 Yukon Dr
Suite 214
Ashburn, VA 20147-6984

Phone

(703) 724-0330

Fax

(703) 724-0811

NPI assigned

May 29, 2007

Last updated

Apr 19, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Roy Park, O.D.NPI 1861596447

Title

Owner

Phone

(703) 724-0330

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Roy Edward Park, OD

  • Optometrist
  • Ashburn, VA
  • NPI 1861596447
  Medicare reassignment Care Compare group NPD Authorized official
• Richard Kuang-Hua Kao, O.D.

  • Optometrist
  • Ashburn, VA
  • NPI 1205985637
  Medicare reassignment Care Compare group NPD
• Jacquelyn Tyra, OD

  • Optometrist
  • Ashburn, VA
  • NPI 1154896363
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303171200000",
    "number": "1811198989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43480 YUKON DR",
            "address_2": "SUITE 214",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201476984",
            "telephone_number": "703-724-0330",
            "fax_number": "703-724-0811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43480 YUKON DR",
            "address_2": "SUITE 214",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201476984",
            "telephone_number": "703-724-0330",
            "fax_number": "703-724-0811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUDOUN EYE ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-29",
        "last_updated": "2011-04-19",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "ROY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-724-0330",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010272815",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea Catrice Brown Logan
• Alexandra Denier Long, PHD
• Ronald Longo, LCSW
• Loudoun Center for Plastic Surgery LLC
• Loudoun Chiropractic
• Loudoun Eye Care
• Loudoun Family Chiropractic LLC
• Loudoun Home Care LLC
• Loudoun Imaging Center
• Loudoun Imaging Center/Ashburn, LLC

• Optometrist in Ashburn, VA
• Providers in Ashburn, VA by specialty
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.