Williamstown Eye Clinic Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

937-0D Issued in WV

Legal business name

WILLIAMSTOWN EYE CLINIC INC.

Practice address

442 Highland Ave
Williamstown, WV 26187-1249

Phone

(304) 375-6468

Fax

(304) 375-6468

NPI assigned

May 10, 2007

Organization subpart

No

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

Authorized official

Name

Mitchell Lee Koerber, ODNPI 1801851316

Title

Optomitrist

Phone

(304) 375-6468

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mitchell Lee Koerber, OD

  • Corneal and Contact Management Optometrist
  • Williamstown, WV
  • NPI 1801851316
  Medicare reassignment Authorized official
• Ronald David Frame, OD

  • Corneal and Contact Management Optometrist
  • Parkersburg, WV
  • NPI 1609831874
  NPD (past)

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277942400000",
    "number": "1013121680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "442 HIGHLAND AVE",
            "city": "WILLIAMSTOWN",
            "state": "WV",
            "postal_code": "261871249",
            "telephone_number": "304-375-6468",
            "fax_number": "304-375-6468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "442 HIGHLAND AVE",
            "city": "WILLIAMSTOWN",
            "state": "WV",
            "postal_code": "261871249",
            "telephone_number": "304-375-6468",
            "fax_number": "304-375-6468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAMSTOWN EYE CLINIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2010-07-01",
        "status": "A",
        "authorized_official_last_name": "KOERBER",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OPTOMITRIST",
        "authorized_official_telephone_number": "304-375-6468",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WV",
            "license": "937-0D",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0149872000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Johnna Helene Watson
• Kristen G Weekley
• Ashley Marie Wells
• Jason White
• Wanda White
• Williamstown Medical Service, Inc.
• Williamstown Pharmacy Inc
• Myranda Wilson
• Terri Wilson
• Grace Lea Wineman

• Optometrist in Williamstown, WV
• Providers in Williamstown, WV by specialty
• Optometrist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.