Individual provider Active NPI

Robert L Salth, OD

  • Optometrist
  • Stratford, NJ
National Provider Identifier
1013098565
Registry record updated Jun 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
02828 Issued in NJ
Practice address
123 E Laurel Rd
Stratford, NJ 08084-1324
Phone
(856) 784-0936
Fax
(856) 784-1062
NPI assigned
Oct 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 02828 NJ Primary

Addresses

Primary practice location

123 E Laurel Rd
Stratford, NJ 08084-1324

Mailing address

123 E Laurel Rd
Stratford, NJ 08084-1324
Phone (856) 784-0936

Other identifiers 1

IdentifierTypeStateIssuer
0396401MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
02828NJMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214179200000",
    "number": "1013098565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 E LAUREL RD",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841324",
            "telephone_number": "856-784-0936",
            "fax_number": "856-784-1062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 E LAUREL RD",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841324",
            "telephone_number": "856-784-0936",
            "fax_number": "856-784-1062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALTH",
        "first_name": "ROBERT",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2008-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "02828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0396401",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stratford, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.