Douglas J Wine, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

T1670 Issued in OH

Practice address

140 W Spring St
Saint Marys, OH 45885-2312

Phone

(419) 394-2397

Fax

(419) 394-2398

NPI assigned

Sep 25, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• John M. Price OD, Inc.

  • Optometrist
  • Oakwood, OH
  • NPI 1376612135
  NPD (past)
• John M. Price OD, Inc.

  • Optometrist
  • Saint Marys, OH
  • NPI 1871677427
  NPD (past)

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285718400000",
    "number": "1376643445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 W SPRING ST",
            "city": "SAINT MARYS",
            "state": "OH",
            "postal_code": "458852312",
            "telephone_number": "419-394-2397",
            "fax_number": "419-394-2398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 W SPRING ST",
            "city": "SAINT MARYS",
            "state": "OH",
            "postal_code": "458852312",
            "telephone_number": "419-394-2397",
            "fax_number": "419-394-2398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINE",
        "first_name": "DOUGLAS",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2010-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3979",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "T1670",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0916941",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Wiener, NP-C
• Wilson Orthopedic and Sports PT
• Michelle Wilson, SLP
• Nicholas D Wilson, PT
• Clarinda Yvette Wine
• Jalyn Yvette Wine, STNA
• Susan Marie Wiseman, R.D., L.D.
• Wishing Well Clinic & Spa, LLC
• Jessica Jean Wuebker, APRN-CNP
• Thomas Joseph Zegarski, MD

• Optometrist in Saint Marys, OH
• Providers in Saint Marys, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2010; 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.