James H Bardenwerper, OD
Individual provider Active NPI Optometrist · Madison, WI
NPI 1568428852 · NPPES record last updated Jan 17, 2018
Key facts
- NPI
- 1568428852
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 1853-035 (WI)
- Practice address
- 1821 S Stoughton Rd
Madison, WI 53716-2257 - Phone
- (608) 260-6000
- Fax
- (608) 260-6716
- NPI assigned
- Apr 25, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1853 | WI | MD | Psychologist |
| 1853-035 | WI | MD | Optometrist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1853-035 | WI | Yes |
Addresses
Primary practice location
1821 S Stoughton Rd
Madison, WI 53716-2257
Mailing address
1821 S Stoughton Rd
Madison, WI 53716-2257
Phone (608) 260-6000
Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 17, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.