Brett K Radow, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

WV0730 Issued in WV

Practice address

149 Main St
Spencer, WV 25276-1414

Phone

(304) 927-5112

NPI assigned

Sep 8, 2005

Reactivated

Apr 3, 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 2

Medicare fee-for-service enrollment

Enrolled in WV

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: loseyhannah@drradow.eyefinity-direct.com
• Direct secure messaging: brettradow@drradow.eyefinity-direct.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Hospital Development Co

  • Rural Health Clinic/Center
  • Left Hand, WV
  • NPI 1790745677

  WV

  Medicare reassignment NPD
• Hospital Development Co

  • Rural Health Clinic/Center
  • Arnoldsburg, WV
  • NPI 1053059881
  NPD
• Hospital Development Co

  • Emergency Medicine Physician
  • Spencer, WV
  • NPI 1184721581
  NPD
• Hospital Development Co

  • Ambulance
  • Spencer, WV
  • NPI 1710697040
  NPD
• Hospital Development Co

  • Rural Health Clinic/Center
  • Spencer, WV
  • NPI 1790745172
  NPD (past)

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

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1154315992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HOSPITAL DR",
            "city": "SPENCER",
            "state": "WV",
            "postal_code": "252761050",
            "telephone_number": "304-927-6884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 MAIN ST",
            "city": "SPENCER",
            "state": "WV",
            "postal_code": "252761414",
            "telephone_number": "304-927-5112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADOW",
        "first_name": "BRETT",
        "middle_name": "K",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-08",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "deactivation_date": "2006-03-25",
        "reactivation_date": "2006-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WV",
            "license": "WV0730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0150656000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "001720163",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jamie Lynn Proctor
• Whitney Proctor
• Daniel B. Prudich, MD
• Psych Services Associates, Inc
• Psych Services of Roane County
• Madison Raines
• Paitlyn Raines
• Christopher Ray Rhodes
• Madison Rhodes
• Marianne Rhodes

• All providers in Spencer, WV
• Optometrist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.