Individual provider Active NPI

Lois Margaret Meacham, O.D.

  • Optometrist
  • Lino Lakes, MN
National Provider Identifier
1902929391
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
MN2566 Issued in MN
Practice address
749 Apollo Dr
Lino Lakes, MN 55014-3035
Phone
(651) 784-7625
Fax
(651) 784-7627
NPI assigned
Apr 9, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X MN2566 MN Primary

Addresses

Primary practice location

749 Apollo Dr
Lino Lakes, MN 55014-3035

Mailing address

PO Box 488
Circle Pines, MN 55014-0488
Phone (651) 784-3375

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140110000351 MN Practitioner - Optometry 6709014111 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shoptikal LLCGroup PAC ID 1456684471, 192 clinicians

Practice addresses (Care Compare)

1004 18TH Ave NW
Suite D
Austin, MN 55912-1993
Phone (507) 437-8228

1267 W Broadway Ave
Suite 300
Forest Lake, MN 55025-1418
Phone (651) 899-1789

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2566MNMDProfessional Counselor
MN2566MNMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Shoptikal LLC Optometrist CurrentSince Aug 12, 2021 Accepting new patients
Shoptikal LLC Optometrist Current Accepting new patients
Shoptikal LLC Optometrist CurrentSince Aug 12, 2021 Accepting new patients

Locations

1004 18th Ave NW
Ste D
Austin, MN 55912
Phone (507) 437-8228

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902929391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 488",
            "city": "CIRCLE PINES",
            "state": "MN",
            "postal_code": "550140488",
            "telephone_number": "651-784-3375",
            "fax_number": "651-784-3382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "749 APOLLO DR",
            "city": "LINO LAKES",
            "state": "MN",
            "postal_code": "550143035",
            "telephone_number": "651-784-7625",
            "fax_number": "651-784-7627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEACHAM",
        "first_name": "LOIS",
        "middle_name": "MARGARET",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "MN2566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lino Lakes, MN

Sources for this page

Verify at the official NPI Registry.