NPIMap

Organization Active NPI

Laughlin and Wade, Optometrists

  • Optometrist
  • Fairmont, WV
National Provider Identifier
1477753838
Registry record updated Apr 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
646OD Issued in WV
Legal business name
LAUGHLIN AND WADE, OPTOMETRISTS
Practice address
405 Locust Ave
Fairmont, WV 26554-4717
Phone
(304) 366-2020
NPI assigned
Jul 23, 2007
Last updated
Apr 22, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2008

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

Authorized official

Name
Dr. J Keith Wade, ODNPI 1295850410
Title
Partner
Phone
(304) 366-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 646OD WV Primary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 729OD WV

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
0012623000MedicaidWV

National Provider Directory

National Provider Directory

Locations

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208822400000",
    "number": "1477753838",
    "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"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAUGHLIN AND WADE, OPTOMETRISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-23",
        "last_updated": "2008-04-22",
        "status": "A",
        "authorized_official_last_name": "WADE",
        "authorized_official_first_name": "J",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "304-366-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "WV",
            "license": "646OD",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "WV",
            "license": "729OD",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012623000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairmont, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; 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.