Active NPI
Douglas Kent Graebe, O. D.
- Optometrist
- Wheeling, WV
National Provider Identifier
1215071733
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 682-D
- Practice address
- 50 Washington Ave
Wheeling, WV 26003-6241 - Phone
- (740) 695-3822
- Fax
- (740) 695-3822
- NPI assigned
- Feb 17, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 682-D | WV | Primary |
Addresses
Primary practice location
50 Washington Ave
Wheeling, WV 26003-6241
Mailing address
40 Williamsburg Cir
Wheeling, WV 26003-5525
Phone (304) 242-1145
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180319001439 | WV | Practitioner - Optometry | 8527320191 | Practice locations: Triadelphia, WV |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 682-D | WV | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1215071733",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 WILLIAMSBURG CIR",
"city": "WHEELING",
"state": "WV",
"postal_code": "260035525",
"telephone_number": "304-242-1145"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 WASHINGTON AVE",
"city": "WHEELING",
"state": "WV",
"postal_code": "260036241",
"telephone_number": "740-695-3822",
"fax_number": "740-695-3822"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAEBE",
"first_name": "DOUGLAS",
"middle_name": "KENT",
"name_prefix": "Dr.",
"credential": "O. D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WV",
"license": "682-D",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wheeling, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.