William H. Bennett, O.D.
Individual provider Active NPI Optometrist · Orrville, OH
NPI 1124038823 · NPPES record last updated Feb 24, 2015
Key facts
- NPI
- 1124038823
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 3278 (OH)
- Practice address
- 417 W Market St
Orrville, OH 44667-1822 - Phone
- (330) 683-3963
- Fax
- (330) 683-3453
- NPI assigned
- Aug 8, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120406000308 | OH | Practitioner - Optometry | 3779697263 | Practice locations: Orrville, OH |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 3278 | OH | Yes |
Addresses
Primary practice location
417 W Market St
Orrville, OH 44667-1822
Mailing address
417 W Market St
Orrville, OH 44667-1822
Phone (330) 683-3963
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0128787 | Other | OH | ANTHEM PROVIDER NUMBER |
| 0465661 | Other | OH | PTAN/MEDICARE PROVIDER NUMBER |
| 0339842 | Medicaid | OH | |
| 341225963 | Other | OH | MMO PROVIDER NUMBER |
Other providers in Orrville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 24, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.