Individual provider Active NPI

C David Laughlin, OD

  • Optometrist
  • Fairmont, WV
National Provider Identifier
1336264654
Registry record updated May 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
646OD Issued in WV
Practice address
405 Locust Ave
Fairmont, WV 26554-4717
Phone
(304) 366-2020
Fax
(304) 367-0863
NPI assigned
Mar 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 646OD WV Primary

Addresses

Primary practice location

405 Locust Ave
Fairmont, WV 26554-4717

Mailing address

405 Locust Ave
Fairmont, WV 26554-4717
Phone (304) 366-2020

Other identifiers 1

IdentifierTypeStateIssuer
0150304000MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
646ODWVMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of West Virginia, PLLC Optometrist Current Accepting new patients

Locations

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

838 Somerset Blvd
Charles Town, WV 25414
Phone (304) 725-4828

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": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211414400000",
    "number": "1336264654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 LOCUST AVE",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265544717",
            "telephone_number": "304-366-2020",
            "fax_number": "304-367-0863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 LOCUST AVE",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265544717",
            "telephone_number": "304-366-2020",
            "fax_number": "304-367-0863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUGHLIN",
        "first_name": "C",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2008-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WV",
            "license": "646OD",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0150304000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairmont, WV

Sources for this page

Verify at the official NPI Registry.