Individual provider Active NPI

Wendy S Rothman, O.D.

  • Optometrist
  • Rockville, MD
National Provider Identifier
1336240480
Registry record updated Aug 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA0733 Issued in MD
Practice address
15200 Shady Grove Rd
Suite 100
Rockville, MD 20850-3218
Phone
(301) 670-1212
Fax
(301) 216-9692
NPI assigned
Sep 25, 2006
Last updated
Aug 14, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA0733 MD Primary

Addresses

Primary practice location

15200 Shady Grove Rd
Suite 100
Rockville, MD 20850-3218

Mailing address

15200 Shady Grove Rd
Suite 100
Rockville, MD 20850-3218
Phone (301) 670-1212

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)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
TA1210MDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Shady Grove Eye & Vision Care, LLC Optometrist PastSince Jan 1, 2004 Accepting new patients
Dr Alan N Glazier Optometrist PA Optometrist Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250208000000",
    "number": "1336240480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15200 SHADY GROVE RD",
            "address_2": "SUITE 100",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503218",
            "telephone_number": "301-670-1212",
            "fax_number": "301-216-9692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15200 SHADY GROVE RD",
            "address_2": "SUITE 100",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503218",
            "telephone_number": "301-670-1212",
            "fax_number": "301-216-9692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHMAN",
        "first_name": "WENDY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2009-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA0733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2009; 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.