Individual provider Active NPI

Nathaniel S. Stevens, O.D.

  • Optometrist
  • Saint Albans, WV
National Provider Identifier
1063724003
Registry record updated Jun 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1080-OD Issued in WV
Practice address
205 4TH Ave
Saint Albans, WV 25177-2821
Phone
(304) 727-5237
Fax
(304) 727-4051
NPI assigned
Jul 7, 2010
Last updated
Jun 24, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1080-OD WV Primary

Addresses

Primary practice location

205 4TH Ave
Saint Albans, WV 25177-2821

Mailing address

205 4TH Ave
Saint Albans, WV 25177-2821
Phone (304) 727-5237

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110909002395 WV Practitioner - Optometry 8123298783 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DRS Whittington and Whittington PTRGroup PAC ID 5698704351, 7 clinicians

Practice addresses (Care Compare)

3840 Pennsylvania Ave
Charleston, WV 25302-4650
Phone (304) 342-0660

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery28

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1080-ODWVMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
DRS Whittington & Whittington PTR Optometrist CurrentSince Jan 20, 2024 Accepting new patients
Thomas E. Griffith O.D. Optometrist Past Accepting new patients

Locations

3840 Pennsylvania Ave
Charleston, WV 25302
Phone (304) 342-0660

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1278460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308873600000",
    "number": "1063724003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 4TH AVE",
            "city": "SAINT ALBANS",
            "state": "WV",
            "postal_code": "251772821",
            "telephone_number": "304-727-5237",
            "fax_number": "304-727-4051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 4TH AVE",
            "city": "SAINT ALBANS",
            "state": "WV",
            "postal_code": "251772821",
            "telephone_number": "304-727-5237",
            "fax_number": "304-727-4051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "NATHANIEL",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-07",
        "last_updated": "2011-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WV",
            "license": "1080-OD",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Albans, WV

Sources for this page

Verify at the official NPI Registry.