Alfred C. Wermuth, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

18001756B Issued in IN

Practice address

1221 Medical Park Dr
Fort Wayne, IN 46825-5827

Phone

(260) 471-2000

Fax

(260) 471-2100

NPI assigned

Mar 19, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205452800000",
    "number": "1295859528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 MEDICAL PARK DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468255827",
            "telephone_number": "260-471-2000",
            "fax_number": "260-471-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 MEDICAL PARK DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468255827",
            "telephone_number": "260-471-2000",
            "fax_number": "260-471-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WERMUTH",
        "first_name": "ALFRED",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2008-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18001756B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Wendell
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• Steven Richard Wert, DDS
• Barry Thomas Wertz, PA-C
• Emily Wertz, M.D.
• Reese Mackenzie Weslow, PA-C
• West Central Fire District

• Optometrist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2008; 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.

Verify at the official NPI Registry.