Active NPI
John Charles Cobbett, O.D.
- Optometrist
- Fairbanks, AK
National Provider Identifier
1154430866
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OP0076
- Practice address
- 1867 Airport Way Ste 150a
Fairbanks, AK 99701-4061 - Phone
- (907) 452-2131
- Fax
- (907) 452-2618
- NPI assigned
- Aug 29, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 | OP0076 | AK | Primary |
Addresses
Primary practice location
1867 Airport Way Ste 150a
Fairbanks, AK 99701-4061
Mailing address
PO Box 55777
North Pole, AK 99705-0777
Phone (907) 452-2131
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OP0076 | Other | AK | MEDICAID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OP0076 | AK | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323734400000",
"number": "1154430866",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 55777",
"city": "NORTH POLE",
"state": "AK",
"postal_code": "997050777",
"telephone_number": "907-452-2131",
"fax_number": "907-452-2618"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1867 AIRPORT WAY STE 150A",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997014061",
"telephone_number": "907-452-2131",
"fax_number": "907-452-2618"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COBBETT",
"first_name": "JOHN",
"middle_name": "CHARLES",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-29",
"last_updated": "2011-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "AK",
"license": "OP0076",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID",
"identifier": "OP0076",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fairbanks, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.