Individual provider Active NPI

Chris R Fields, OD

  • Optometrist
  • Lebanon, NH
National Provider Identifier
1548378532
Registry record updated Mar 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0696 Issued in NH
Practice address
410 Miracle Mile Plaza
Suite 13
Lebanon, NH 03766
Phone
(603) 448-2575
Fax
(603) 448-2710
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0696 NH Primary
Optometrist 152W00000X 0300000299 VT

Addresses

Primary practice location

410 Miracle Mile Plaza
Suite 13
Lebanon, NH 03766

Mailing address

410 Miracle Mile Plaza
Suite 13
Lebanon, NH 03766
Phone (603) 448-2575

Other identifiers 2

IdentifierTypeStateIssuer
30350494MedicaidNH
0RE5453MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20060407000160 NH Practitioner - Optometry 5193766541 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

410 Miracle Mile Plaza
Suite 13
Lebanon, NH 03766-2639
Phone (603) 448-2575

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0696NHMDOptometrist
0300000299VTMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Jordan Family Eyecare Inc Optometrist CurrentSince Jan 24, 2009 Accepting new patients
Fields of Vision Eye Care Inc Optometrist CurrentSince Apr 12, 2011 Accepting new patients

Locations

410 Miracle Mile
Ste 13
Lebanon, NH 03766
Phone (603) 448-2575

410 Miracle Mile
Lebanon, NH 03766
Phone (603) 276-3260

8 Lilac Mall
Rochester, NH 03867
Phone (603) 335-6666

Organizations & group practices 2

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301529600000",
    "number": "1548378532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 MIRACLE MILE PLAZA",
            "address_2": "SUITE 13",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "03766",
            "telephone_number": "603-448-2575",
            "fax_number": "603-448-2710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 MIRACLE MILE PLAZA",
            "address_2": "SUITE 13",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "03766",
            "telephone_number": "603-448-2575",
            "fax_number": "603-448-2710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIELDS",
        "first_name": "CHRIS",
        "middle_name": "R",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2011-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NH",
            "license": "0696",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VT",
            "license": "0300000299",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30350494",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0RE5453",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

Verify at the official NPI Registry.