Charles M. Plourde, O.D.

Primary specialty

Low Vision Rehabilitation OptometristTaxonomy code 152WL0500X

License

OPT656 Issued in ME

Practice address

67 Main St
Van Buren, ME 04785-1028

Phone

(207) 868-3341

Fax

(207) 868-3441

NPI assigned

Jan 13, 2007

Last updated

Jan 11, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Charles M. Plourde

  • Low Vision Rehabilitation Optometrist
  • Van Buren, ME
  • NPI 1093992760
  Authorized official Same address or phone

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

{
    "created_epoch": "1168646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547164800000",
    "number": "1619028115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 MAIN ST",
            "address_2": "P.O. BOX 300",
            "city": "VAN BUREN",
            "state": "ME",
            "postal_code": "047851028",
            "telephone_number": "207-868-3341",
            "fax_number": "207-868-3441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 MAIN ST",
            "city": "VAN BUREN",
            "state": "ME",
            "postal_code": "047851028",
            "telephone_number": "207-868-3341",
            "fax_number": "207-868-3441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLOURDE",
        "first_name": "CHARLES",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-13",
        "last_updated": "2019-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ME",
            "license": "OPT656",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "ME",
            "license": "OPT656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111810000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Northern Aroostook Alt. Inc.
• Ouellette Foster Home
• Elaine B Ouellette, PA-C
• Myles Peter Ouellette, LADC, CCS
• Pines Health Services (St John Valley Health Center)
• Rhonda Parent
• Rite Aid of Maine Inc (Rite Aid Pharmacy 03900)
• Sheryl a. Parent
• McKayla Diane Soucy, CRMA, DSP, CNA
• Soucy's Foster Home

• Low Vision Rehabilitation Optometrist in Van Buren, ME
• Providers in Van Buren, ME by specialty
• Low Vision Rehabilitation Optometrist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2019; 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.