Active NPI
William G Ahlfeld, O.D.
- Optometrist
- Fort Branch, IN
National Provider Identifier
1295775484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 18001924A
- Practice address
- 800 E Mulberry St
Fort Branch, IN 47648-1644 - Phone
- (812) 753-4991
- NPI assigned
- Jun 7, 2006
- Sex
- Male
- Sole proprietor
- No
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 | 18001924A | IN | Primary |
Addresses
Primary practice location
800 E Mulberry St
Fort Branch, IN 47648-1644
Mailing address
RR 1 Box 362B
Fort Branch, IN 47648-9728
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100122210A | Medicaid | IN |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348531200000",
"number": "1295775484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "RR 1 BOX 362B",
"city": "FORT BRANCH",
"state": "IN",
"postal_code": "476489728"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 E MULBERRY ST",
"city": "FORT BRANCH",
"state": "IN",
"postal_code": "476481644",
"telephone_number": "812-753-4991"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AHLFELD",
"first_name": "WILLIAM",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-07",
"last_updated": "2012-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IN",
"license": "18001924A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100122210A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Branch, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.