Individual provider Active NPI

Stephen Fredrick Lord, OD

  • Optometrist
  • Wytheville, VA
National Provider Identifier
1326092032
Registry record updated Oct 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618000224 Issued in VA
Practice address
530W Ridge Rd
Wytheville, VA 24382-1188
Phone
(276) 223-0033
Fax
(276) 223-0327
NPI assigned
May 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618000224 VA Primary

Addresses

Primary practice location

530W Ridge Rd
Wytheville, VA 24382-1188

Mailing address

530W Ridge Rd
Wytheville, VA 24382-1188
Phone (276) 223-0033

Other identifiers 1

IdentifierTypeStateIssuer
9235469MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20060911000103 VA Practitioner - Optometry 9931103728 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1989
Medicare assignment
May accept Medicare assignment
Group practices
Wythe Eye Associates Amanda Brewer-Smith OD IncGroup PAC ID 1153370531, 5 clinicians

Practice addresses (Care Compare)

530 W Ridge Rd
Wytheville, VA 24382-1848
Phone (276) 223-0033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0618000224VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Wythe Eye Associates Amanda Brewer-Smith OD Inc Optometrist CurrentSince Aug 4, 2011 Accepting new patients
Stephen F Lord, OD Optometrist PastSince Jan 1, 1990 Accepting new patients

Locations

14 Westwood Medical Park
Bluefield, VA 24605
Phone (276) 322-7335

952 E Stuart Dr
Galax, VA 24333
Phone (276) 236-4673

1510 Bob White Blvd
Pulaski, VA 24301
Phone (540) 980-1965

334 N Washington Ave
Pulaski, VA 24301
Phone (540) 980-5890

530 W Ridge Rd
Wytheville, VA 24382
Phone (276) 223-0033

Organizations & group practices 2

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": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444262400000",
    "number": "1326092032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530W RIDGE RD",
            "city": "WYTHEVILLE",
            "state": "VA",
            "postal_code": "243821188",
            "telephone_number": "276-223-0033",
            "fax_number": "276-223-0327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530W RIDGE RD",
            "city": "WYTHEVILLE",
            "state": "VA",
            "postal_code": "243821188",
            "telephone_number": "276-223-0033",
            "fax_number": "276-223-0327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LORD",
        "first_name": "STEPHEN",
        "middle_name": "FREDRICK",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2015-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618000224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9235469",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wytheville, VA

Sources for this page

Verify at the official NPI Registry.