Individual provider Active NPI

Stephen Michael Carr, O.D.

  • Optometrist
  • Trumbull, CT
National Provider Identifier
1174627194
Registry record updated Mar 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
CT2216 Issued in CT
Practice address
6515 Main St
Suite 8 L
Trumbull, CT 06611-1354
Phone
(203) 374-3202
NPI assigned
Sep 11, 2006
Last updated
Mar 24, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X CT2216 CT Primary

Addresses

Primary practice location

6515 Main St
Suite 8 L
Trumbull, CT 06611-1354

Mailing address

531 Fairfield Beach Rd
Fairfield, CT 06824-6740
Phone (203) 255-6039

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2216CTMDBehavioral Analyst
CT2216CTMDOptometrist
002216CTMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395619200000",
    "number": "1174627194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 FAIRFIELD BEACH RD",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068246740",
            "telephone_number": "203-255-6039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6515 MAIN ST",
            "address_2": "SUITE 8 L",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066111354",
            "telephone_number": "203-374-3202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARR",
        "first_name": "STEPHEN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-11",
        "last_updated": "2014-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "CT2216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trumbull, CT

Sources for this page

Verify at the official NPI Registry.