Organization Active NPI

Fox Optical & Gallery LLC

  • Optometrist
  • Bethlehem, PA
National Provider Identifier
1174884944
Registry record updated Jun 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OE006575P Issued in PA
Legal business name
FOX OPTICAL & GALLERY LLC
Practice address
28 E 3Rd St
Bethlehem, PA 18015-1304
Phone
(610) 332-2400
Fax
(610) 332-2402
NPI assigned
Jun 7, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2012

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

Authorized official

Name
Timothy Wynn Fox, O.D.NPI 1851442107
Title
Owner
Phone
(610) 332-2400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OE006575P PA Primary

Addresses

Primary practice location

28 E 3Rd St
Bethlehem, PA 18015-1304

Mailing address

28 E 3Rd St
Bethlehem, PA 18015-1304
Phone (610) 332-2400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120607000265 PA Part B Supplier - Clinic/Group Practice 2860656683 Receives reassigned benefits from 1 practitioner
Practice locations: Bethlehem, PA

National Provider Directory

National Provider Directory

Locations

28 E 3rd St
Bethlehem, PA 18015
Phone (610) 332-2044

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1339027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339027200000",
    "number": "1174884944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 E 3RD ST",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180151304",
            "telephone_number": "610-332-2400",
            "fax_number": "610-332-2402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 E 3RD ST",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180151304",
            "telephone_number": "610-332-2400",
            "fax_number": "610-332-2402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOX OPTICAL & GALLERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-07",
        "last_updated": "2012-06-07",
        "status": "A",
        "authorized_official_last_name": "FOX",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "WYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-332-2400",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OE006575P",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.