Individual provider Active NPI

Charles Edward Daniels III, OD

  • Optometrist
  • Concord, NH
National Provider Identifier
1013648062
Registry record updated Jun 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1048 Issued in NH
Practice address
8 N State St
Concord, NH 03301-4038
Phone
(603) 225-2512
Fax
(603) 225-3249
NPI assigned
Jun 21, 2022
Last updated
Jun 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1048 NH Primary

Addresses

Primary practice location

8 N State St
Concord, NH 03301-4038

Mailing address

8 N State St
Concord, NH 03301-4038
Phone (603) 225-2512

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220831000566 NH Practitioner - Optometry 5496139065 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1048NHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Concord Family Vision, PLLC CurrentSince Sep 1, 2022 Accepting new patients
Joseph P Larochelle Optometrist CurrentSince Jun 26, 2022 Accepting new patients

Locations

8 N State St
Concord, NH 03301
Phone (603) 225-2512

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1655769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1013648062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 N STATE ST",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033014038",
            "telephone_number": "603-225-2512",
            "fax_number": "603-225-3249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 N STATE ST",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033014038",
            "telephone_number": "603-225-2512",
            "fax_number": "603-225-3249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELS",
        "first_name": "CHARLES",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-21",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NH",
            "license": "1048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NH

Sources for this page

Verify at the official NPI Registry.