Individual provider Active NPI

L. Woodrow Story Jr., OPTOMETRIST

  • Optometrist
  • Richmond, VA
National Provider Identifier
1275528150
Registry record updated Sep 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0601000655 Issued in VA
Practice address
11216 Patterson Ave
Richmond, VA 23238-5011
Phone
(804) 740-2303
Fax
(804) 740-2303
NPI assigned
Sep 15, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0601000655 VA Primary

Addresses

Primary practice location

11216 Patterson Ave
Richmond, VA 23238-5011

Mailing address

11216 Patterson Ave
Richmond, VA 23238-5011
Phone (804) 740-2303

Other identifiers 1

IdentifierTypeStateIssuer
9203192MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0601000655VAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221782400000",
    "number": "1275528150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11216 PATTERSON AVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232385011",
            "telephone_number": "804-740-2303",
            "fax_number": "804-740-2303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11216 PATTERSON AVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232385011",
            "telephone_number": "804-740-2303",
            "fax_number": "804-740-2303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STORY",
        "first_name": "L.",
        "middle_name": "WOODROW",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "OPTOMETRIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-15",
        "last_updated": "2008-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0601000655",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9203192",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.