Organization Active NPI

Lally Vision Care, P.C.

  • Optometrist
  • Lee's Summit, MO
National Provider Identifier
1871608265
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T02140 Issued in MO
Legal business name
LALLY VISION CARE, P.C.
Practice address
101 NE Douglas St
Lees Summit, MO 64063-2037
Phone
(816) 524-1616
Fax
(816) 524-7868
NPI assigned
Aug 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Steven Eric Lally, O.D.
Title
President
Phone
(816) 524-1616

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X T02140 MO Primary

Addresses

Primary practice location

101 NE Douglas St
Lees Summit, MO 64063-2037

Mailing address

101 NE Douglas St
Lees Summit, MO 64063-2037
Phone (816) 524-1616

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050518000650 MO Part B Supplier - Clinic/Group Practice 3577504786 Receives reassigned benefits from 1 practitioner
Practice locations: Lees Summit, MO

National Provider Directory

National Provider Directory

Locations

101 NE Douglas St
Lees Summit, MO 64063
Phone (816) 524-1616

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1871608265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 NE DOUGLAS ST",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640632037",
            "telephone_number": "816-524-1616",
            "fax_number": "816-524-7868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 NE DOUGLAS ST",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640632037",
            "telephone_number": "816-524-1616",
            "fax_number": "816-524-7868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LALLY VISION CARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LALLY",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "816-524-1616",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T02140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lee's Summit, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.