Individual provider Active NPI

John David Higgins, O.D.

  • Optometrist
  • Kittery, ME
National Provider Identifier
1083707582
Registry record updated Dec 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT569 Issued in ME
Practice address
99 US Route 1 Byp
Suite a
Kittery, ME 03904-1570
Phone
(207) 439-0410
Fax
(207) 439-8353
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT569 ME Primary

Addresses

Primary practice location

99 US Route 1 Byp
Suite a
Kittery, ME 03904-1570

Mailing address

99 US Route 1 Byp
Suite a
Kittery, ME 03904-1570
Phone (207) 439-0410

Other identifiers 2

IdentifierTypeStateIssuer
280240099MedicaidME
30008032MedicaidNH

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
OPT569MEMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228867200000",
    "number": "1083707582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 US ROUTE 1 BYP",
            "address_2": "SUITE A",
            "city": "KITTERY",
            "state": "ME",
            "postal_code": "039041570",
            "telephone_number": "207-439-0410",
            "fax_number": "207-439-8353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 US ROUTE 1 BYP",
            "address_2": "SUITE A",
            "city": "KITTERY",
            "state": "ME",
            "postal_code": "039041570",
            "telephone_number": "207-439-0410",
            "fax_number": "207-439-8353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIGGINS",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2008-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ME",
            "license": "OPT569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280240099",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30008032",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kittery, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.