Individual provider Active NPI

Fred B Setzer Jr., OD

  • Optometrist
  • Birmingham, AL
National Provider Identifier
1053396465
Registry record updated Jan 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
S364TA082 Issued in AL
Practice address
One West Lakeshore Drive
Birmingham, AL 35209-7271
Phone
(205) 941-2020
Fax
(205) 397-4190
NPI assigned
Dec 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X S364TA082 AL Primary

Addresses

Primary practice location

One West Lakeshore Drive
Birmingham, AL 35209-7271

Mailing address

324C Edwards Lake Parkway
Suite 100
Birmingham, AL 35235-3218
Phone (205) 949-2020

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

State licenses

LicenseStateTypeSpecialty
S364TA082ALMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1134000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200268800000",
    "number": "1053396465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324C EDWARDS LAKE PARKWAY",
            "address_2": "SUITE 100",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352353218",
            "telephone_number": "205-949-2020",
            "fax_number": "205-949-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE WEST LAKESHORE DRIVE",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352097271",
            "telephone_number": "205-941-2020",
            "fax_number": "205-397-4190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SETZER",
        "first_name": "FRED",
        "middle_name": "B",
        "name_suffix": "Jr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-08",
        "last_updated": "2008-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S364TA082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.