Charles William Fornara, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

5622 Issued in OH

Practice address

224 Chestnut Street
Coshocton, OH 43812-1164

Phone

(740) 622-1484

Fax

(740) 622-1540

NPI assigned

Nov 15, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Optometry

Education

Southern California College of Optometry, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• devoted network organization-598bd2d4-c652-473f-ba7a-132f674c8eb6
• OH PPO

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.

• Coshocton Vision Center, LLC

  dba Optics Plus Vision Center

  • Optometrist
  • Coshocton, OH
  • NPI 1376640821
  Medicare reassignment NPD Authorized official
• Coshocton Vision Center, LLC

  dba Tri-Valley Vision Center

  • Optometrist
  • Dresden, OH
  • NPI 1801104260
  NPD Authorized official

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571184000000",
    "number": "1003898156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 CHESTNUT STREET",
            "city": "COSHOCTON",
            "state": "OH",
            "postal_code": "438121164",
            "telephone_number": "740-622-1484",
            "fax_number": "740-622-1540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 CHESTNUT STREET",
            "city": "COSHOCTON",
            "state": "OH",
            "postal_code": "438121164",
            "telephone_number": "740-622-1484",
            "fax_number": "740-622-1540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORNARA",
        "first_name": "CHARLES",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2019-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "713",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5622",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2685018",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Ann Ferguson
• Tonya Jean Fish
• Tiffany N Fisher, QMHS
• Courtney Fleming, PHARMD
• Renee Y Fleming, LSW
• Charles Fowler, APRN-BC
• Rajene Gerette Fox, NP
• Taylor Fox
• Joseph France
• Jaime Faye Frantom, CDCA.195114

• Optometrist in Coshocton, OH
• Providers in Coshocton, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.