Wickford Optical, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

ODTG 00369 Issued in RI

Legal business name

WICKFORD OPTICAL, LLC

Practice address

7805 Post Rd
North Kingstown, RI 02852-4405

Phone

(401) 294-1010

Fax

(401) 295-2050

NPI assigned

Apr 23, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Domenic A Coppolino, O.D.

Title

Partner

Phone

(401) 294-1010

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• James P Theroux, O.D.

  • Optometrist
  • Woonsocket, RI
  • NPI 1326074972
  NPD (past)

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267488000000",
    "number": "1295953768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7805 POST RD",
            "city": "NORTH KINGSTOWN",
            "state": "RI",
            "postal_code": "028524405",
            "telephone_number": "401-294-1010",
            "fax_number": "401-295-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7805 POST RD",
            "city": "NORTH KINGSTOWN",
            "state": "RI",
            "postal_code": "028524405",
            "telephone_number": "401-294-1010",
            "fax_number": "401-295-2050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WICKFORD OPTICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2010-03-02",
        "status": "A",
        "authorized_official_last_name": "COPPOLINO",
        "authorized_official_first_name": "DOMENIC",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "401-294-1010",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "RI",
            "license": "ODTG 00369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "WO16877",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bryana FC White, MA PYSCH
• Gerald J White
• Wickford Family Medicine LLC
• Wickford Family Practice LLC
• Wickford Internists, Inc.
• Wickford Orthodontics
• Wickford Orthodontics, LLC
• Jennifer Susan Wilkinson Shepherd, M.S.
• Peter Wilkinson, APRN, NP-C
• Sharnese K Williams

• Durable Medical Equipment & Medical Supplies in North Kingstown, RI
• Providers in North Kingstown, RI by specialty
• Durable Medical Equipment & Medical Supplies in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2010; 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.