Individual provider Active NPI

Stanley D Lower, OD

  • Optometrist
  • Deerfield, IL
National Provider Identifier
1831178276
Registry record updated May 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18001944A Issued in IN
Practice address
775 Waukegan Rd
Suite 200
Deerfield, IL 60015-4342
Phone
(800) 317-0711
Fax
(800) 434-7113
NPI assigned
Jan 13, 2006
Last updated
May 9, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18001944A IN Primary

Addresses

Primary practice location

775 Waukegan Rd
Suite 200
Deerfield, IL 60015-4342

Mailing address

31 S Fairway Dr
Alexandria, IN 46001-2811
Phone (765) 724-3610

Other identifiers 2

IdentifierTypeStateIssuer
000000333790OtherINANTHEM
200486520MedicaidIN

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

LicenseStateTypeSpecialty
18001944AINMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Primesource Healthcare Systems, Inc. Optometrist Past Accepting new patients
Primesource Healthcare Systems, Inc. Past Accepting new patients

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, 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": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210291200000",
    "number": "1831178276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 S FAIRWAY DR",
            "city": "ALEXANDRIA",
            "state": "IN",
            "postal_code": "460012811",
            "telephone_number": "765-724-3610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 WAUKEGAN RD",
            "address_2": "SUITE 200",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600154342",
            "telephone_number": "800-317-0711",
            "fax_number": "800-434-7113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOWER",
        "first_name": "STANLEY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-13",
        "last_updated": "2008-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18001944A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000333790",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200486520",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Deerfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.