Organization Active NPI

C. Richard Snively, Jr., O.D.,P.C.

  • Optometrist
  • Vienna, VA
National Provider Identifier
1013130939
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618000132 Issued in VA
Legal business name
C. RICHARD SNIVELY, JR., O.D.,P.C.
Practice address
120 Beulah Rd NE
Vienna, VA 22180-4745
Phone
(703) 938-7633
Fax
(703) 938-4407
NPI assigned
Apr 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Richard Snively, O.D.
Title
President
Phone
(703) 938-7633

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 0618000132 VA Primary

Addresses

Primary practice location

120 Beulah Rd NE
Vienna, VA 22180-4745

Mailing address

120 Beulah Rd NE
Vienna, VA 22180-4745
Phone (703) 938-7633

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100326000029 DC Part B Supplier - Clinic/Group Practice 7517093859 Receives reassigned benefits from 5 practitioners
Practice locations: Vienna, VA

National Provider Directory

National Provider Directory

Locations

6699 Springfield Center Dr
Rm 116
Springfield, VA 22150

120 Beulah Rd NE
Ste 101
Vienna, VA 22180
Phone (703) 938-7633

120 Beulah Rd NE
Vienna, VA 22180
Phone (703) 938-2000

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013130939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 BEULAH RD NE",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221804745",
            "telephone_number": "703-938-7633",
            "fax_number": "703-938-4407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 BEULAH RD NE",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221804745",
            "telephone_number": "703-938-7633",
            "fax_number": "703-938-4407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C. RICHARD SNIVELY, JR., O.D.,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SNIVELY",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-938-7633",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618000132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vienna, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.