C. Roger Armstrong, O.D.
Individual provider Active NPI Optometrist · Danvers, MA
NPI 1013090893 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1013090893
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 2428 (MA)
- Practice address
- Wal-Mart Vision Center
55 Brooksby Villaga Way
Danvers, MA 01923 - Phone
- (978) 777-9263
- Fax
- (978) 777-6963
- NPI assigned
- Oct 23, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2428 | MA | MD | Optometrist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2428 | MA | Yes |
Addresses
Primary practice location
Wal-Mart Vision Center
55 Brooksby Villaga Way
Danvers, MA 01923
Mailing address
55 Brooksby Village Way
Danvers, MA 01923
Phone (978) 777-9263
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0351393 | Medicaid | MS |
Other providers in Danvers, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.