NPIMap

Organization Active NPI

Theodore P Werblin MD PC

  • Ophthalmology Physician
  • Princeton, WV
National Provider Identifier
1609061399
Registry record updated Jul 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
12870 Issued in WV
Legal business name
THEODORE P WERBLIN MD PC
Practice address
1051 Stafford Dr
Princeton, WV 24740-2409
Phone
(304) 487-6123
Fax
(304) 425-2631
NPI assigned
Sep 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2020

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

Authorized official

Name
Mrs. Sara Werblin
Title
Office Administrator
Phone
(304) 487-6123

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 12870 WV Primary
Ophthalmologic Surgery Clinic/Center 261QS0132X

Addresses

Primary practice location

1051 Stafford Dr
Princeton, WV 24740-2409

Mailing address

1051 Stafford Dr
PO Box 5879
Princeton, WV 24740-2409
Phone (304) 487-6123

Other identifiers 1

IdentifierTypeStateIssuer
0096798000MedicaidWV

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address theodore.werblin.p1@direct.werblin.nextgenshare.com

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1189036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595376000000",
    "number": "1609061399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 STAFFORD DR",
            "address_2": "PO BOX 5879",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402409",
            "telephone_number": "304-487-6123",
            "fax_number": "304-425-2631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 STAFFORD DR",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402409",
            "telephone_number": "304-487-6123",
            "fax_number": "304-425-2631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THEODORE P WERBLIN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-06",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A",
        "authorized_official_last_name": "WERBLIN",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "304-487-6123",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "WV",
            "license": "12870",
            "primary": true
        },
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0096798000",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "theodore.werblin.p1@direct.werblin.nextgenshare.com",
            "affiliation": "N",
            "address_1": "1051 Stafford Dr",
            "city": "Princeton",
            "state": "WV",
            "country_code": "US",
            "postal_code": "247402409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Princeton, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.