David Fenwick

Primary specialty

OptometristTaxonomy code 152W00000X

License

18002215B Issued in IN

Practice address

424 N Main St
Suite 4
Middlebury, IN 46540-8987

Phone

(574) 825-3818

Fax

(574) 825-9497

NPI assigned

Feb 8, 2006

Last updated

Apr 4, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Quality Optical Inc

  • Optometrist
  • Middlebury, IN
  • NPI 1689635831
  Medicare reassignment Authorized official
• Quality Optical Inc

  • Optometrist
  • Plymouth, IN
  • NPI 1801845995
  NPD Authorized official

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207267200000",
    "number": "1104899426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 N MAIN ST",
            "address_2": "SUITE 4",
            "city": "MIDDLEBURY",
            "state": "IN",
            "postal_code": "465408987",
            "telephone_number": "574-825-3818",
            "fax_number": "574-825-9497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 N MAIN ST",
            "address_2": "SUITE 4",
            "city": "MIDDLEBURY",
            "state": "IN",
            "postal_code": "465408987",
            "telephone_number": "574-825-3818",
            "fax_number": "574-825-9497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENWICK",
        "first_name": "DAVID",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2008-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002215B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100325370",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Donald L Munn (Crystal Valley Professional Consultants)
• Dorwyn C Collier, P.C. (Windsor WorkCare)
• Rachel E. Dunham, MD
• Leeann Marie Enix, NP
• Dawn Renee Ernsberger, LCSW
• Firefly Home Care LLC
• Firefly Home Health LLC
• G. Weldon Friesen, MD
• Elizabeth B Gingrich, MD
• Gailya Nicole Go, FNP-C

• Optometrist in Middlebury, IN
• Providers in Middlebury, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.