Active NPI
Paul Thomas Ahern, O.D.
- Optometrist
- Dyersville, IA
National Provider Identifier
1104892116
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1609
- Practice address
- 420 1St Ave E
Dyersville, IA 52040-1326 - Phone
- (563) 875-8123
- Fax
- (563) 875-7874
- NPI assigned
- Feb 28, 2006
- 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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1609 | IA | Primary |
Addresses
Primary practice location
420 1St Ave E
Dyersville, IA 52040-1326
Mailing address
PO Box 160
Dyersville, IA 52040-0160
Phone (563) 875-8123
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 |
|---|---|---|---|
| 1609 | IA | MD | Physical Therapist |
| 01609 | IA | MD | Physical Rehabilitation Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190937600000",
"number": "1104892116",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 160",
"city": "DYERSVILLE",
"state": "IA",
"postal_code": "520400160",
"telephone_number": "563-875-8123",
"fax_number": "563-875-7874"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 1ST AVE E",
"city": "DYERSVILLE",
"state": "IA",
"postal_code": "520401326",
"telephone_number": "563-875-8123",
"fax_number": "563-875-7874"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AHERN",
"first_name": "PAUL",
"middle_name": "THOMAS",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-28",
"last_updated": "2007-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IA",
"license": "1609",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dyersville, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.