Active NPI
Glenn Howard Hermann, O.D.
- Optometrist
- Collinsville, VA
National Provider Identifier
1093750317
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 0618000497
- Practice address
- 3416 Virginia Ave
Suite #3
Collinsville, VA 24078-2240 - Phone
- (276) 747-4488
- Fax
- (276) 647-7569
- NPI assigned
- Jun 19, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 0618000497 | VA | Primary |
| Corneal and Contact Management Optometrist | 152WC0802X | 0618000497 | VA |
Addresses
Primary practice location
3416 Virginia Ave
Suite #3
Collinsville, VA 24078-2240
Mailing address
3416 Virginia Ave
Suite #3
Collinsville, VA 24078-2240
Phone (276) 747-4488
Other identifiers 16
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 009231854 | Medicaid | VA | |
| 541741479 | Other | VA | ACCORDIA NATIONAL |
| 541741479 | Medicaid | VA | |
| 910899 | Other | VA | COLE |
| 541741479 | Other | VA | ALL ALLIANCE PPO |
| 040437 | Other | VA | BLUE CROSS BLUE SHIELD |
| 541741479 | Other | VA | CIGNA HEALTHCARE |
| 541741479 | Other | VA | MAIL HANDLERS BENEFIT |
| 541741479 | Other | VA | AETNA |
| 450168 | Other | VA | COBINED INSURANCE CO OF A |
| 541741479 | Other | VA | UNITED HEALTH CARE |
| 541741479 | Other | VA | CONSECO HEALTH INSURANCE |
| 541741479 | Other | VA | GAATEWAY/PRIMARY PHYSICAN |
| 5674 | Other | VA | VISION WITH B/C B/S |
| 541741479 | Other | VA | CARILION HEALTH PLANS |
| 9615238 | Other | VA | CIGNA HEALTHCARE |
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 |
|---|---|---|---|
| 0618000497 | VA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478217600000",
"number": "1093750317",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3416 VIRGINIA AVE",
"address_2": "SUITE #3",
"city": "COLLINSVILLE",
"state": "VA",
"postal_code": "240782240",
"telephone_number": "276-747-4488",
"fax_number": "276-647-7569"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3416 VIRGINIA AVE",
"address_2": "SUITE #3",
"city": "COLLINSVILLE",
"state": "VA",
"postal_code": "240782240",
"telephone_number": "276-747-4488",
"fax_number": "276-647-7569"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERMANN",
"first_name": "GLENN",
"middle_name": "HOWARD",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-19",
"last_updated": "2016-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "VA",
"license": "0618000497",
"primary": true
},
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "VA",
"license": "0618000497",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "009231854",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ACCORDIA NATIONAL",
"identifier": "541741479",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "541741479",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COLE",
"identifier": "910899",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALL ALLIANCE PPO",
"identifier": "541741479",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "040437",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA HEALTHCARE",
"identifier": "541741479",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAIL HANDLERS BENEFIT",
"identifier": "541741479",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "541741479",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COBINED INSURANCE CO OF A",
"identifier": "450168",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH CARE",
"identifier": "541741479",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CONSECO HEALTH INSURANCE",
"identifier": "541741479",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GAATEWAY/PRIMARY PHYSICAN",
"identifier": "541741479",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VISION WITH B/C B/S",
"identifier": "5674",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARILION HEALTH PLANS",
"identifier": "541741479",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA HEALTHCARE",
"identifier": "9615238",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Collinsville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.