Organization Active NPI

Douglas R. Myers, O.D., Inc.

  • Optometrist
  • Chico, CA
National Provider Identifier
1679528947
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5438 T Issued in CA
Legal business name
DOUGLAS R. MYERS, O.D., INC.
Practice address
119 Yellowstone Dr
Chico, CA 95973-5811
Phone
(530) 891-1146
Fax
(530) 891-0123
NPI assigned
May 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Douglas Richard Myers, O.D.NPI 1750320800
Title
Optometrist / Ceo
Phone
(530) 891-1146

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 5438 T CA Primary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 9963 T CA

Addresses

Primary practice location

119 Yellowstone Dr
Chico, CA 95973-5811

Mailing address

119 Yellowstone Dr
Chico, CA 95973-5811
Phone (530) 891-1146

Other identifiers 1

IdentifierTypeStateIssuer
GSD000690MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101116000830 CA Part B Supplier - Clinic/Group Practice 4385839356 Receives reassigned benefits from 2 practitioners
Practice locations: Chico, CA

National Provider Directory

National Provider Directory

Locations

119 Yellowstone Dr
Chico, CA 95973
Phone (530) 891-1146

Practitioners & affiliated clinicians

Practitioners 2

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": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679528947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 YELLOWSTONE DR",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959735811",
            "telephone_number": "530-891-1146",
            "fax_number": "530-891-0123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 YELLOWSTONE DR",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959735811",
            "telephone_number": "530-891-1146",
            "fax_number": "530-891-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS R. MYERS, O.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "OPTOMETRIST / CEO",
        "authorized_official_telephone_number": "530-891-1146",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "5438 T",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "9963 T",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GSD000690",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chico, CA

Sources for this page

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

Verify at the official NPI Registry.