Active NPI
John C Alexander, OD
- Optometrist
- Meadville, PA
National Provider Identifier
1063476166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OEG000490
- Practice address
- 830 Market St
Meadville, PA 16335-3314 - Phone
- (814) 724-2700
- Fax
- (814) 724-2705
- NPI assigned
- Apr 14, 2006
- Sex
- Male
- Sole proprietor
- No
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 | OEG000490 | PA | Primary |
Addresses
Primary practice location
830 Market St
Meadville, PA 16335-3314
Mailing address
426 Edgewood Dr
Meadville, PA 16335-1317
Phone (814) 724-2700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0005458230001 | Medicaid | PA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| OEG000490 | PA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1501113600000",
"number": "1063476166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "426 EDGEWOOD DR",
"city": "MEADVILLE",
"state": "PA",
"postal_code": "163351317",
"telephone_number": "814-724-2700",
"fax_number": "814-724-2705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "830 MARKET ST",
"city": "MEADVILLE",
"state": "PA",
"postal_code": "163353314",
"telephone_number": "814-724-2700",
"fax_number": "814-724-2705"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALEXANDER",
"first_name": "JOHN",
"middle_name": "C",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-14",
"last_updated": "2017-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "PA",
"license": "OEG000490",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0005458230001",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Meadville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.