Active NPI
Richard Fennig, LICENSED OPTICIAN
- Optician
- Centerville, OH
National Provider Identifier
1083007587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- SC 2197
- Practice address
- 101 E Alex-Bell Rd #120
Centerville, OH 45459-2789 - Phone
- (937) 435-2437
- Fax
- (937) 435-9579
- NPI assigned
- Mar 9, 2015
- Last updated
- Mar 9, 2015
- 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 |
|---|---|---|---|---|
| Optician | 156FX1800X | SC 2197 | OH | Primary |
Addresses
Primary practice location
101 E Alex-Bell Rd #120
Centerville, OH 45459-2789
Mailing address
101 E Alex Bell Rd
#120
Centerville, OH 45459-2753
Phone (937) 435-2437
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SC 2197 | OH | MD | Optician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Village Eye Care, Inc. | Past | Accepting new patients | |
| West Point Optical Centerville | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Optometrist
- Lebanon, OH
- NPI 1134255474
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1425859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1425859200000",
"number": "1083007587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 E ALEX BELL RD",
"address_2": "#120",
"city": "CENTERVILLE",
"state": "OH",
"postal_code": "454592753",
"telephone_number": "937-435-2437",
"fax_number": "937-435-9579"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 E ALEX-BELL RD #120",
"city": "CENTERVILLE",
"state": "OH",
"postal_code": "454592789",
"telephone_number": "937-435-2437",
"fax_number": "937-435-9579"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FENNIG",
"first_name": "RICHARD",
"credential": "LICENSED OPTICIAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-03-09",
"last_updated": "2015-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "OH",
"license": "SC 2197",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Centerville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.