Individual provider Active NPI

William Fletcher Damron, OD

  • Optometrist
  • Portsmouth, VA
National Provider Identifier
1194747782
Registry record updated Jun 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618000258 Issued in VA
Practice address
226 Fort LN
Portsmouth, VA 23704-2220
Phone
(757) 393-6131
Fax
(757) 393-0976
NPI assigned
Jul 24, 2006
Last updated
Jun 30, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618000258 VA Primary

Addresses

Primary practice location

226 Fort LN
Portsmouth, VA 23704-2220

Mailing address

226 Fort LN
Portsmouth, VA 23704-2220
Phone (757) 393-6131

Other identifiers 3

IdentifierTypeStateIssuer
91431OtherVAOPTIMA
178557OtherVAANTHEM BCBS
010147760MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20050218000701 VA Practitioner - Optometry 4587616479 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr James V Cornetta LTDGroup PAC ID 1254383136, 4 clinicians

Practice addresses (Care Compare)

226 Fort LN
Portsmouth, VA 23704-2220
Phone (757) 393-6131

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0618000258VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. James V. Cornetta LTD Optometrist CurrentSince Jan 1, 2005 Accepting new patients
Dr PG Moerschell OD Inc Optometrist Past Accepting new patients

Locations

226 Fort Ln
Portsmouth, VA 23704
Phone (757) 393-0976

Organizations & group practices 2

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246320000000",
    "number": "1194747782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 FORT LN",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237042220",
            "telephone_number": "757-393-6131",
            "fax_number": "757-393-0976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 FORT LN",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237042220",
            "telephone_number": "757-393-6131",
            "fax_number": "757-393-0976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMRON",
        "first_name": "WILLIAM",
        "middle_name": "FLETCHER",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2009-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618000258",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA",
            "identifier": "91431",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "178557",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010147760",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, VA

Sources for this page

Verify at the official NPI Registry.