Active NPI
Brian E Wind, D.O.
- Ophthalmology Physician
- Massillon, OH
National Provider Identifier
1164415147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 34. 005043
- Practice address
- 3545 Lincoln Way E
Suite a
Massillon, OH 44646-8624 - Phone
- (330) 837-5191
- Fax
- (330) 837-0755
- NPI assigned
- Aug 25, 2005
- 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 |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 34. 005043 | OH | Primary |
Addresses
Primary practice location
3545 Lincoln Way E
Suite a
Massillon, OH 44646-8624
Mailing address
3545 Lincoln Way E
Suite a
Massillon, OH 44646-3707
Phone (330) 837-5191
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0929875 | Medicaid | OH |
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
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34. 005043 | OH | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340755200000",
"number": "1164415147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3545 LINCOLN WAY E",
"address_2": "SUITE A",
"city": "MASSILLON",
"state": "OH",
"postal_code": "446463707",
"telephone_number": "330-837-5191",
"fax_number": "330-837-0755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3545 LINCOLN WAY E",
"address_2": "SUITE A",
"city": "MASSILLON",
"state": "OH",
"postal_code": "446468624",
"telephone_number": "330-837-5191",
"fax_number": "330-837-0755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIND",
"first_name": "BRIAN",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-25",
"last_updated": "2012-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "OH",
"license": "34. 005043",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0929875",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Massillon, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.