Active NPI
Stanley R Black, O.D.
- Optometrist
- Thornton, CO
National Provider Identifier
1851464366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 830
- Practice address
- 12450 York St
Thornton, CO 80241-2741 - Phone
- (303) 452-2020
- Fax
- (303) 452-0934
- NPI assigned
- Nov 15, 2006
- Sex
- Male
- 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 | 830 | CO | Primary |
Addresses
Primary practice location
12450 York St
Thornton, CO 80241-2741
Mailing address
4 Garden Ctr
Ste 100
Broomfield, CO 80020-7026
Phone (303) 469-1941
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1338768000000",
"number": "1851464366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 GARDEN CTR",
"address_2": "STE 100",
"city": "BROOMFIELD",
"state": "CO",
"postal_code": "800207026",
"telephone_number": "303-469-1941",
"fax_number": "303-469-6634"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12450 YORK ST",
"city": "THORNTON",
"state": "CO",
"postal_code": "802412741",
"telephone_number": "303-452-2020",
"fax_number": "303-452-0934"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACK",
"first_name": "STANLEY",
"middle_name": "R",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-15",
"last_updated": "2012-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CO",
"license": "830",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Thornton, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.