Organization Active NPI

Fick Eyecare, Inc

  • Optometrist
  • Fairmont, WV
National Provider Identifier
1053473827
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
FICK EYECARE, INC
Practice address
32 Tygart Mall Rd
Inside Walmart
Fairmont, WV 26554
Phone
(304) 366-3425
NPI assigned
Dec 15, 2006
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
Jim M Fick, OD
Title
President
Phone
(304) 739-2698

Specialties & licenses 1

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

Addresses

Primary practice location

32 Tygart Mall Rd
Inside Walmart
Fairmont, WV 26554

Mailing address

PO Box 5096
Whitehall Station
Fairmont, WV 26555-5096
Phone (304) 366-3425

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070816000430 WV Part B Supplier - Clinic/Group Practice 5193817427 Receives reassigned benefits from 2 practitioners
Practice locations: Clarksburg, WV

National Provider Directory

National Provider Directory

Locations

538 Emily Dr
Clarksburg, WV 26301
Phone (304) 566-7709

536 Emily Dr
#B
Clarksburg, WV 26301
Phone (304) 556-7709

Practitioners & affiliated clinicians

Practitioners 3

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": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053473827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5096",
            "address_2": "WHITEHALL STATION",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265555096",
            "telephone_number": "304-366-3425",
            "fax_number": "304-366-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 TYGART MALL RD",
            "address_2": "INSIDE WALMART",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "26554",
            "telephone_number": "304-366-3425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FICK EYECARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FICK",
        "authorized_official_first_name": "JIM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-739-2698",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairmont, WV

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.