Active NPI
Fred William Carter III, OD
- Optometrist
- Bishop, CA
National Provider Identifier
1063571966
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 5120T
- Practice address
- 293 Willow Street
Bishop, CA 93514 - Phone
- (760) 872-7511
- Fax
- (760) 872-2094
- NPI assigned
- Dec 6, 2006
- Last updated
- Oct 3, 2012
- 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 | 5120T | CA | Primary |
Addresses
Primary practice location
293 Willow Street
Bishop, CA 93514
Mailing address
293 Willow Street
Bishop, CA 93514
Phone (760) 872-7511
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 |
|---|---|---|---|
| 5120 | CA | MD | Addiction (Substance Use Disorder) Counselor |
| 5120T | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349222400000",
"number": "1063571966",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "293 WILLOW STREET",
"city": "BISHOP",
"state": "CA",
"postal_code": "93514",
"telephone_number": "760-872-7511",
"fax_number": "760-872-2094"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "293 WILLOW STREET",
"city": "BISHOP",
"state": "CA",
"postal_code": "93514",
"telephone_number": "760-872-7511",
"fax_number": "760-872-2094"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARTER",
"first_name": "FRED",
"middle_name": "WILLIAM",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-06",
"last_updated": "2012-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "5120T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bishop, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.