Individual provider Active NPI

Frederick Gerald Bohne, LDO

  • Optician
  • W Henrietta, NY
National Provider Identifier
1649786112
Registry record updated Dec 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
C008464-1 Issued in NY
Practice address
24 Reids GRV
W Henrietta, NY 14586-9653
Phone
(585) 243-4004
Fax
(585) 243-4009
NPI assigned
Dec 20, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X COO8464-1 NY
Optician 156FX1800X C008464-1 NY Primary

Addresses

Primary practice location

24 Reids GRV
W Henrietta, NY 14586-9653

Mailing address

24 Reids GRV
W Henrietta, NY 14586-9653
Phone (585) 243-4004

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
C008464-1NYMDOptician
COO8464-1NYMDOptician

NPI Registry JSON

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

{
    "created_epoch": "1513728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513728000000",
    "number": "1649786112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 REIDS GRV",
            "city": "W HENRIETTA",
            "state": "NY",
            "postal_code": "145869653",
            "telephone_number": "585-243-4004",
            "fax_number": "585-243-4009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 REIDS GRV",
            "city": "W HENRIETTA",
            "state": "NY",
            "postal_code": "145869653",
            "telephone_number": "585-243-4004",
            "fax_number": "585-243-4009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHNE",
        "first_name": "FREDERICK",
        "middle_name": "GERALD",
        "credential": "LDO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-12-20",
        "last_updated": "2017-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NY",
            "license": "COO8464-1",
            "primary": false
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NY",
            "license": "C008464-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in W Henrietta, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2017; 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.