Active NPI
James Laurence Edick, O.D.
- Optometrist
- Mount Vernon, OH
National Provider Identifier
1679629521
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 3795
- Practice address
- 5 W High St
Mount Vernon, OH 43050-3282 - Phone
- (740) 397-3355
- Fax
- (740) 397-2843
- NPI assigned
- Jan 25, 2007
- Last updated
- Mar 28, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 3795 | OH | Primary |
Addresses
Primary practice location
5 W High St
Mount Vernon, OH 43050-3282
Mailing address
5 W High St
Mount Vernon, OH 43050-3282
Phone (740) 397-3355
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0850431 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Ohio State University - College of Optometry, 1983
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
5 W High St
PO Box 71
Mt Vernon, OH 43050-3282
Phone (740) 397-3355
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3795 | OH | MD | Chiropractor |
Organizations & group practices 1
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.
-
- Optometrist
- Mount Vernon, OH
- NPI 1841458411
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206662400000",
"number": "1679629521",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 W HIGH ST",
"city": "MOUNT VERNON",
"state": "OH",
"postal_code": "430503282",
"telephone_number": "740-397-3355",
"fax_number": "740-397-2843"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 W HIGH ST",
"city": "MOUNT VERNON",
"state": "OH",
"postal_code": "430503282",
"telephone_number": "740-397-3355",
"fax_number": "740-397-2843"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDICK",
"first_name": "JAMES",
"middle_name": "LAURENCE",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-25",
"last_updated": "2008-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OH",
"license": "3795",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0850431",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mount Vernon, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.