Active NPI
Robert Joseph Werner, OD
- Optometrist
- Port Orchard, WA
National Provider Identifier
1558340802
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OD00003541
- Practice address
- 3497 Bethel Rd SE
Port Orchard, WA 98366 - Phone
- (360) 329-5033
- Fax
- (360) 874-6670
- NPI assigned
- Jan 14, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OD00003541 | WA | Primary |
Addresses
Primary practice location
3497 Bethel Rd SE
Port Orchard, WA 98366
Mailing address
5701 Banner Rd SE
Port Orchard, WA 98367
Phone (360) 473-3410
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2034015 | Medicaid | WA | |
| G8900672 | Other | WA | MEDICARE PTAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472774400000",
"number": "1558340802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5701 BANNER RD SE",
"city": "PORT ORCHARD",
"state": "WA",
"postal_code": "98367",
"telephone_number": "360-473-3410",
"fax_number": "360-874-6670"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3497 BETHEL RD SE",
"city": "PORT ORCHARD",
"state": "WA",
"postal_code": "98366",
"telephone_number": "360-329-5033",
"fax_number": "360-874-6670"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WERNER",
"first_name": "ROBERT",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-01-14",
"last_updated": "2016-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WA",
"license": "OD00003541",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2034015",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "G8900672",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Port Orchard, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.