Active NPI
Carol Dibble Record, O.D.
- Optometrist
- Charlottesville, VA
National Provider Identifier
1033153978
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 0618000232
- Practice address
- 1450 Sachem PL
Ste 202
Charlottesville, VA 22901-2554 - Phone
- (434) 978-4090
- Fax
- (434) 978-1005
- NPI assigned
- Jun 14, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 0618000232 | VA | Primary |
Addresses
Primary practice location
1450 Sachem PL
Ste 202
Charlottesville, VA 22901-2554
Mailing address
1450 Sachem PL
Ste 202
Charlottesville, VA 22901-2554
Phone (434) 978-4090
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 186515 | Other | VA | ANTHEM BC/BS PJP OFFICE |
| 113326 | Other | VA | ANTHEM BC/BS, SACHEM |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280275200000",
"number": "1033153978",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1450 SACHEM PL",
"address_2": "STE 202",
"city": "CHARLOTTESVILLE",
"state": "VA",
"postal_code": "229012554",
"telephone_number": "434-978-4090",
"fax_number": "434-978-1005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1450 SACHEM PL",
"address_2": "STE 202",
"city": "CHARLOTTESVILLE",
"state": "VA",
"postal_code": "229012554",
"telephone_number": "434-978-4090",
"fax_number": "434-978-1005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RECORD",
"first_name": "CAROL",
"middle_name": "DIBBLE",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-06-14",
"last_updated": "2010-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "VA",
"license": "0618000232",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BC/BS PJP OFFICE",
"identifier": "186515",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BC/BS, SACHEM",
"identifier": "113326",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charlottesville, VA
- George Bradley Reahl
- Robert Zane Reasoner, PA-C
- Maria Rebeiz
- Giuseppe Rebellato, D.D.S.
- Abril Dawn Reck, NP
- Stephen Wayne Record, O.D.
- Rector & Visitors of the University of Virginia (Uva Specialty Pharmacy)
- Rector & Visitors of the University of Virginia (UVA Health Sciences Center)
- Rector & Visitors of the University of Virginia (UVA Health Pharmacy Ivy Road)
- Rector & Visitors of the University of Virginia (UVA Health Sciences Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.