Active NPI
Deborah Witt Church, OPTICIAN
- Optician
- Martinsville, VA
National Provider Identifier
1306901772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 1101001459
- Practice address
- 240 Commonwealth Blvd W
Martinsville, VA 24112-1800 - Phone
- (276) 638-4461
- Fax
- (276) 638-1859
- NPI assigned
- Dec 26, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Optician | 156FX1800X | 1101001459 | VA | Primary |
Addresses
Primary practice location
240 Commonwealth Blvd W
Martinsville, VA 24112-1800
Mailing address
80 Witts LN
Bassett, VA 24055-8013
Phone (276) 629-5588
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1101001459 | VA | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1306901772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "80 WITTS LN",
"city": "BASSETT",
"state": "VA",
"postal_code": "240558013",
"telephone_number": "276-629-5588",
"fax_number": "276-638-1859"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "240 COMMONWEALTH BLVD W",
"city": "MARTINSVILLE",
"state": "VA",
"postal_code": "241121800",
"telephone_number": "276-638-4461",
"fax_number": "276-638-1859"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHURCH",
"first_name": "DEBORAH",
"middle_name": "WITT",
"name_prefix": "Mrs.",
"credential": "OPTICIAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "VA",
"license": "1101001459",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Martinsville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.