Active NPI
John R Prewett O D Inc
- Optometrist
- Santa Maria, CA
National Provider Identifier
1548308489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- CA7312
- Legal business name
- JOHN R PREWETT O D INC
- Practice address
- 1429 S Broadway
Santa Maria, CA 93454-6913 - Phone
- (805) 925-9575
- Fax
- (805) 739-8886
- NPI assigned
- Feb 2, 2007
- Last updated
- Aug 19, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. John Rader Prewett, OD
- Title
- Owner
- Phone
- (805) 925-9575
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | CA7312 | CA | Primary |
Addresses
Primary practice location
1429 S Broadway
Santa Maria, CA 93454-6913
Mailing address
1429 S Broadway
Santa Maria, CA 93454-6913
Phone (805) 925-9575
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GSD005040 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 2
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.
-
- Optometrist
- Santa Maria, CA
- NPI 1902987001
-
- Optometrist
- Arroyo Grande, CA
- NPI 1093695827
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170374400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1408406400000",
"number": "1548308489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1429 S BROADWAY",
"city": "SANTA MARIA",
"state": "CA",
"postal_code": "934546913",
"telephone_number": "805-925-9575",
"fax_number": "805-739-8886"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1429 S BROADWAY",
"city": "SANTA MARIA",
"state": "CA",
"postal_code": "934546913",
"telephone_number": "805-925-9575",
"fax_number": "805-739-8886"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JOHN R PREWETT O D INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-02",
"last_updated": "2014-08-19",
"status": "A",
"authorized_official_last_name": "PREWETT",
"authorized_official_first_name": "JOHN",
"authorized_official_middle_name": "RADER",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "805-925-9575",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "OD"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "CA7312",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GSD005040",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Santa Maria, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.