Individual provider Active NPI

Erika P Densmore, O.D.

  • Optometrist
  • Lubbock, TX
National Provider Identifier
1962402131
Registry record updated Jan 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5389T Issued in TX
Practice address
4413 82ND St
#110
Lubbock, TX 79424-3384
Phone
(806) 798-7030
Fax
(806) 798-2611
NPI assigned
Jul 28, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5389T TX Primary

Addresses

Primary practice location

4413 82ND St
#110
Lubbock, TX 79424-3384

Mailing address

4413 82ND St
#110
Lubbock, TX 79424-3384
Phone (806) 798-7030

Other identifiers 1

IdentifierTypeStateIssuer
019232001MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20120629000458 TX Practitioner - Optometry 6901010768 Practice locations: Lubbock, TX

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4413 82ND St
Lubbock, TX 79424-3366
Phone (806) 798-7030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5389TTXMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294963200000",
    "number": "1962402131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4413 82ND ST",
            "address_2": "#110",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794243384",
            "telephone_number": "806-798-7030",
            "fax_number": "806-798-2611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4413 82ND ST",
            "address_2": "#110",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794243384",
            "telephone_number": "806-798-7030",
            "fax_number": "806-798-2611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENSMORE",
        "first_name": "ERIKA",
        "middle_name": "P",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-28",
        "last_updated": "2011-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5389T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019232001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.