Individual provider Active NPI

Douglas Arthur Safley, OD

  • Optometrist
  • Havre, MT
National Provider Identifier
1093729535
Registry record updated Nov 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
412 Issued in MT
Practice address
416 3Rd Ave
Havre, MT 59501-3914
Phone
(406) 265-1231
Fax
(406) 265-1603
NPI assigned
Jul 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 412 MT Primary

Addresses

Primary practice location

416 3Rd Ave
Havre, MT 59501-3914

Mailing address

PO Box 551
Havre, MT 59501-0551
Phone (406) 265-1231

Other identifiers 2

IdentifierTypeStateIssuer
26220OtherMTBLUE CROSS BLUE SHIELD
48-2274MedicaidMT

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

LicenseStateTypeSpecialty
412MTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Frances Mahon Deaconess Hospital 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.

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196121600000",
    "number": "1093729535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 551",
            "city": "HAVRE",
            "state": "MT",
            "postal_code": "595010551",
            "telephone_number": "406-265-1231",
            "fax_number": "406-265-1603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 3RD AVE",
            "city": "HAVRE",
            "state": "MT",
            "postal_code": "595013914",
            "telephone_number": "406-265-1231",
            "fax_number": "406-265-1603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAFLEY",
        "first_name": "DOUGLAS",
        "middle_name": "ARTHUR",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MT",
            "license": "412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "26220",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "48-2274",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Havre, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2007; 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.