Individual provider Active NPI

Benjamin C Fisher, O.D.

  • Optometrist
  • Ripley, WV
National Provider Identifier
1306038153
Registry record updated Jan 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1043-OD Issued in WV
Practice address
200 Academy Dr
Ripley, WV 25271-1157
Phone
(304) 373-1256
NPI assigned
Aug 15, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1043-OD WV Primary

Addresses

Primary practice location

200 Academy Dr
Ripley, WV 25271-1157

Mailing address

200 Academy Dr
Ripley, WV 25271-1157
Phone (304) 373-1256

Other identifiers 1

IdentifierTypeStateIssuer
WV10020281OtherMEDICARE PTAN

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070925000101 WV Practitioner - Optometry 5496849283 Practice locations: Ripley, WV

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2007
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

200 Academy Dr
Ripley, WV 25271-1157
Phone (304) 373-1256

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Stephen L. Gaal & Associates Optometrist PastSince Feb 1, 1996 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1187136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358899200000",
    "number": "1306038153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 ACADEMY DR",
            "city": "RIPLEY",
            "state": "WV",
            "postal_code": "252711157",
            "telephone_number": "304-373-1256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 ACADEMY DR",
            "city": "RIPLEY",
            "state": "WV",
            "postal_code": "252711157",
            "telephone_number": "304-373-1256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "BENJAMIN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-15",
        "last_updated": "2013-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WV",
            "license": "1043-OD",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "WV10020281",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ripley, WV

Sources for this page

Verify at the official NPI Registry.