Terry L Williams O D Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

645D Issued in WV

Legal business name

TERRY L WILLIAMS O D INC

Practice address

12 Wheeling Ave
Glen Dale, WV 26038-1529

Phone

(304) 843-1445

Fax

(304) 843-1446

NPI assigned

Nov 18, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Terry L Williams, ODNPI 1306922125

Title

Owner/Optometrist

Phone

(304) 843-1445

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Glen Dale Vision Center Doing business as

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

Locations

Practitioners 4

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

• Terry L Williams, O.D.

  • Optometrist
  • Glen Dale, WV
  • NPI 1306922125
  Medicare reassignment NPD Authorized official
• Linda L Davison, MA CCCA

  • Audiologist
  • St Clairsville, OH
  • NPI 1134215874
  NPD
• Sara Arlene Tennant, AUD

  • Audiologist
  • Washington, PA
  • NPI 1972238921
  NPD
• Suzanne Marie Kubancik, M.S.CCC-A

  • Audiologist
  • Saint Clairsville, OH
  • NPI 1275876419
  NPD (past)

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235347200000",
    "number": "1053393645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 WHEELING AVE",
            "city": "GLEN DALE",
            "state": "WV",
            "postal_code": "260381529",
            "telephone_number": "304-843-1445",
            "fax_number": "304-843-1446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 WHEELING AVE",
            "city": "GLEN DALE",
            "state": "WV",
            "postal_code": "260381529",
            "telephone_number": "304-843-1445",
            "fax_number": "304-843-1446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERRY L WILLIAMS O D INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-18",
        "last_updated": "2009-02-23",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "304-843-1445",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WV",
            "license": "645D",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOUNTAIN STATE BLUE CROSS",
            "identifier": "001720254",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Glen Dale Vision Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anna Marie Smith
• Jill Spangler
• Brittany Nichole Speed, DO
• Hany Maher Tadros, MD
• John J Templeton, M.D.
• Christine Thames
• Elizabeth Tucker, PHARMD, BCPS
• United Hospital Center, Inc.
• Urgent Care, Inc - West Virginia
• Andrea Rochelle Varner, REGISTERED NURSE

• Optometrist in Glen Dale, WV
• Providers in Glen Dale, WV by specialty
• Optometrist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2009; 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.