Clyde M Fenton, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3023 Issued in OH

Practice address

2002 Robinson Ave
Portsmouth, OH 45662-3650

Phone

(740) 353-5351

Fax

(740) 353-8647

NPI assigned

Dec 13, 2006

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 OH

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

Ohio State University - College of Optometry, 1972

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

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378166400000",
    "number": "1104987007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 ROBINSON AVE",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456623650",
            "telephone_number": "740-353-5351",
            "fax_number": "740-353-8647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 ROBINSON AVE",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456623650",
            "telephone_number": "740-353-5351",
            "fax_number": "740-353-8647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENTON",
        "first_name": "CLYDE",
        "middle_name": "M",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2013-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0344541",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Milton Farley III, DDS
• Mackie Farley
• Benjamin Franklin Farmer, CDCA
• Joshua Timothy Faulkner
• Cora Ann Feeman
• Nicholas Lee Ferguson
• William Corey Ferguson, CRNA
• Estella Berniece Ferrell, LCSWA
• Megan A Ferrell, LPN
• Teresa Lynn Fetty

• Optometrist in Portsmouth, OH
• Providers in Portsmouth, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2013; 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.