George D. Bertherman,O.D., Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

GEORGE D. BERTHERMAN,O.D., INC.

Practice address

1466 Broad St
Providence, RI 02905-2836

Phone

(401) 941-6221

Fax

(401) 941-6227

NPI assigned

Feb 22, 2007

Organization subpart

No

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

Authorized official

Name

George D BerthermanNPI 1629074141

Title

President

Phone

(401) 941-6221

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in RI

Enrollment records 1

Locations

Practitioners 4

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

• George D Bertherman, O.D

  • Optometrist
  • Providence, RI
  • NPI 1629074141
  Medicare reassignment Care Compare group NPD Authorized official
• Samantha Marie Bertherman, OD

  • Optometrist
  • Providence, RI
  • NPI 1790353308
  Medicare reassignment Care Compare group NPD
• Robert Mitchell Thacker, O.D.

  • Optometrist
  • Providence, RI
  • NPI 1003874991
  Medicare reassignment Care Compare group NPD
• Lynn Vere Miller, O.D.

  • Optometrist
  • North Kingstown, RI
  • NPI 1376808568
  Medicare reassignment NPD

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664496000000",
    "number": "1316072143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1466 BROAD ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029052836",
            "telephone_number": "401-941-6221",
            "fax_number": "401-941-6227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1466 BROAD ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029052836",
            "telephone_number": "401-941-6221",
            "fax_number": "401-941-6227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGE D. BERTHERMAN,O.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-30",
        "status": "A",
        "authorized_official_last_name": "BERTHERMAN",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "401-941-6221"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316072",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Genter's Pharmacy Corp (NDS pharmacy)
• Holly Amber Gentile, PA-C
• Lauren Gentile
• Bethany Gentilesco, MD
• Georgina Genuario, RN
• Chandler S George, MD
• Lorie A George
• Marianella George, LICSW
• Michael Austin George, MD
• Naomi R George, M.D.

• Optometrist in Providence, RI
• Providers in Providence, RI by specialty
• Optometrist in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.