Organization Active NPI

Optometric Physicians of Parkersburg Inc

  • Corneal and Contact Management Optometrist
  • Parkersburg, WV
National Provider Identifier
1659459592
Registry record updated Sep 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
Legal business name
OPTOMETRIC PHYSICIANS OF PARKERSBURG INC
Practice address
416 Division St
Parkersburg, WV 26101-5619
Phone
(304) 485-7485
Fax
(304) 485-5410
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2010

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

Authorized official

Name
Patty R Reynolds
Title
Business Manager
Phone
(304) 485-7588

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152WC0802X Primary

Addresses

Primary practice location

416 Division St
Parkersburg, WV 26101-5619

Mailing address

416 Division St
Parkersburg, WV 26101-5619
Phone (304) 485-7485

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050202000500 WV Part B Supplier - Clinic/Group Practice 1153372784 Receives reassigned benefits from 5 practitioners
Practice locations: Parkersburg, WV

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
51D2070622Optometric Physicians of Parkersburg Inc416 Division Street, Parkersburg, WV 26101Certificate of waiverDec 19, 2027

National Provider Directory

National Provider Directory

Locations

416 Division St
Parkersburg, WV 26101
Phone (304) 485-7485

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285632000000",
    "number": "1659459592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 DIVISION ST",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261015619",
            "telephone_number": "304-485-7485",
            "fax_number": "304-485-5410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 DIVISION ST",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261015619",
            "telephone_number": "304-485-7485",
            "fax_number": "304-485-5410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTOMETRIC PHYSICIANS OF PARKERSBURG INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2010-09-28",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "PATTY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "304-485-7588"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parkersburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.