Individual provider Active NPI

Christopher A Stanwick, OD

  • Optometrist
  • Belpre, OH
National Provider Identifier
1174558761
Registry record updated Feb 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3969 Issued in OH
Practice address
2201 Washington Blvd
Belpre, OH 45714-1989
Phone
(740) 423-6533
Fax
(740) 423-8367
NPI assigned
Jul 11, 2006
Last updated
Feb 18, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3969 OH Primary

Addresses

Primary practice location

2201 Washington Blvd
Belpre, OH 45714-1989

Mailing address

2201 Washington Blvd
Belpre, OH 45714-1989
Phone (740) 423-6533

Other identifiers 1

IdentifierTypeStateIssuer
0843010MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ecabp@hotmail.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20100324000074 OH Practitioner - Optometry 1658352885 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Care of McConnelsville LLCGroup PAC ID 3072640630, 3 clinicians

Practice addresses (Care Compare)

2201 Washington Blvd
Belpre, OH 45714-3001
Phone (740) 423-6533

71 E Main St
McConnelsville, OH 43756-1180
Phone (740) 962-4281

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3969OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Care Associates of Beverly LLC Optometrist Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: christopher.stanwick@direct.revolutionehr.com

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1174558761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 WASHINGTON BLVD",
            "city": "BELPRE",
            "state": "OH",
            "postal_code": "457141989",
            "telephone_number": "740-423-6533",
            "fax_number": "740-423-8367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 WASHINGTON BLVD",
            "city": "BELPRE",
            "state": "OH",
            "postal_code": "457141989",
            "telephone_number": "740-423-6533",
            "fax_number": "740-423-8367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANWICK",
        "first_name": "CHRISTOPHER",
        "middle_name": "A",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3969",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0843010",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ecabp@hotmail.com",
            "affiliation": "N",
            "address_1": "2201 Washington Blvd",
            "city": "Belpre",
            "state": "OH",
            "country_code": "US",
            "postal_code": "457141989",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Belpre, OH

Sources for this page

Verify at the official NPI Registry.