Individual provider Active NPI

Larry Wayne Carr, O.D.

  • Occupational Vision Optometrist
  • Saint Marys, WV
National Provider Identifier
1508869298
Registry record updated Oct 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Vision OptometristTaxonomy code 152WX0102X
License
WV723OD Issued in WV
Practice address
214 Washington St
Saint Marys, WV 26170-1041
Phone
(304) 684-2491
Fax
(304) 684-2492
NPI assigned
May 27, 2005
Last updated
Oct 16, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2007

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X WV723OD WV
Pediatric Optometrist 152WP0200X WV723OD WV
Sports Vision Optometrist 152WS0006X WV723OD WV
Occupational Vision Optometrist 152WX0102X WV723OD WV Primary

Addresses

Primary practice location

214 Washington St
Saint Marys, WV 26170-1041

Mailing address

416 S Bradfield Dr
Saint Marys, WV 26170-9771
Phone (304) 684-9594

Other identifiers 1

IdentifierTypeStateIssuer
0149409000MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20070831000419 WV Practitioner - Optometry 6709979008 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

214 Washington St
St Marys, WV 26170-1041
Phone (304) 684-2491

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
WV723ODWVMDPediatric Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Larry W Carr PC CurrentSince Dec 1, 1999 Accepting new patients

Locations

214 Washington St
Saint Marys, WV 26170
Phone (304) 624-2491

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, 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": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192492800000",
    "number": "1508869298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 S BRADFIELD DR",
            "city": "SAINT MARYS",
            "state": "WV",
            "postal_code": "261709771",
            "telephone_number": "304-684-9594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 WASHINGTON ST",
            "city": "SAINT MARYS",
            "state": "WV",
            "postal_code": "261701041",
            "telephone_number": "304-684-2491",
            "fax_number": "304-684-2492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARR",
        "first_name": "LARRY",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-27",
        "last_updated": "2007-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "WV",
            "license": "WV723OD",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "WV",
            "license": "WV723OD",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "WV",
            "license": "WV723OD",
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "WV",
            "license": "WV723OD",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0149409000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Marys, WV

Sources for this page

Verify at the official NPI Registry.