Individual provider Active NPI

David Cooper Snowdon Jr., O.D.

  • Optometrist
  • Charlton, MA
National Provider Identifier
1588728216
Registry record updated Mar 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2825 Issued in MA
Practice address
109-6 Masonic Home Rd
Charlton Optical
Charlton, MA 01507-0194
Phone
(508) 248-1188
Fax
(508) 248-5128
NPI assigned
Dec 20, 2006
Last updated
Mar 11, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2825 MA Primary

Addresses

Primary practice location

109-6 Masonic Home Rd
Charlton Optical
Charlton, MA 01507-0194

Mailing address

17 Orchard Rd
Shrewsbury, MA 01545-2717
Phone (508) 736-6550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20101222000152 MA Practitioner - Optometry 4981892668 Practice locations: Worcester, MA; Charlton, MA

Care Compare profile

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

Practice addresses (Care Compare)

38 A Southbridge St
Worcester, MA 01608-2019
Phone (508) 791-9291

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
D&M Optical & Hearing Aid Corp Past Accepting new patients
Renee M Gomez-Chlebica OD LLC Optometrist PastSince Jun 25, 2016 Accepting new patients
D&M Optical & Hearing Aid Corp Past Accepting new patients
Charlton Optical Past Accepting new patients

Organizations & group practices 4

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": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299801600000",
    "number": "1588728216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 ORCHARD RD",
            "city": "SHREWSBURY",
            "state": "MA",
            "postal_code": "015452717",
            "telephone_number": "508-736-6550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109-6 MASONIC HOME RD",
            "address_2": "CHARLTON OPTICAL",
            "city": "CHARLTON",
            "state": "MA",
            "postal_code": "015070194",
            "telephone_number": "508-248-1188",
            "fax_number": "508-248-5128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNOWDON",
        "first_name": "DAVID",
        "middle_name": "COOPER",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2011-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "2825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlton, MA

Sources for this page

Verify at the official NPI Registry.