Active NPI
T L Malone, O.D.
- Optometrist
- Ogallala, NE
National Provider Identifier
1861544561
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 684
- Practice address
- 401 East a Street
Ogallala, NE 69153-2123 - Phone
- (308) 284-4194
- NPI assigned
- Jan 16, 2007
- Last updated
- Oct 15, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | 684 | NE | Primary |
Addresses
Primary practice location
401 East a Street
Ogallala, NE 69153-2123
Mailing address
401 East a Street
Ogallala, NE 69153-2123
Phone (308) 284-4194
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 06871 | Other | NE | BC/BS OF NE. |
| 47045806700 | Medicaid | NE |
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": "1168905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192406400000",
"number": "1861544561",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 EAST A STREET",
"city": "OGALLALA",
"state": "NE",
"postal_code": "691532123",
"telephone_number": "308-284-4194"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 EAST A STREET",
"city": "OGALLALA",
"state": "NE",
"postal_code": "691532123",
"telephone_number": "308-284-4194"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALONE",
"first_name": "T",
"middle_name": "L",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-16",
"last_updated": "2007-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NE",
"license": "684",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS OF NE.",
"identifier": "06871",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "47045806700",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ogallala, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.