Active NPI
Stephen Parker, OD
- Optometrist
- Springfield, VA
National Provider Identifier
1154403913
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 0601800395
- Practice address
- 6636 Springfield Mall
Springfield, VA 22150-1712 - Phone
- (703) 922-4111
- Fax
- (703) 924-0610
- NPI assigned
- Oct 20, 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 | 0601800395 | VA | Primary |
Addresses
Primary practice location
6636 Springfield Mall
Springfield, VA 22150-1712
Mailing address
11103 West Ave
Suite 6
San Antonio, TX 78213-1370
Phone (210) 524-6509
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC, VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Pennsylvania College of Optometry, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
19100 Ridgewood Pkwy
San Antonio, TX 78259-1828
19100 Ridgewood Pkwy
BLDG 1 7TH Floor
San Antonio, TX 78259-0001
2863 Lawrence Dr
Falls Church, VA 22042-1403
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0601800395 | VA | MD | Optometrist |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1154403913",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11103 WEST AVE",
"address_2": "SUITE 6",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782131370",
"telephone_number": "210-524-6509",
"fax_number": "210-524-6587"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6636 SPRINGFIELD MALL",
"city": "SPRINGFIELD",
"state": "VA",
"postal_code": "221501712",
"telephone_number": "703-922-4111",
"fax_number": "703-924-0610"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARKER",
"first_name": "STEPHEN",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "VA",
"license": "0601800395",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Springfield, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.