Active NPI
Robert L King, D.O.
- Optician
- Brockton, MA
National Provider Identifier
1679639926
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 1894
- Practice address
- 495 Westgate Dr
Suite 1
Brockton, MA 02301-1833 - Phone
- (508) 584-5151
- Fax
- (508) 586-5382
- NPI assigned
- Dec 29, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Optician | 156FX1800X | 1894 | MA | Primary |
Addresses
Primary practice location
495 Westgate Dr
Suite 1
Brockton, MA 02301-1833
Mailing address
495 Westgate Dr
Suite 1
Brockton, MA 02301-1833
Phone (508) 584-5151
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
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1894 | MA | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1679639926",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "495 WESTGATE DR",
"address_2": "SUITE 1",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023011833",
"telephone_number": "508-584-5151",
"fax_number": "508-586-5382"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "495 WESTGATE DR",
"address_2": "SUITE 1",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023011833",
"telephone_number": "508-584-5151",
"fax_number": "508-586-5382"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "ROBERT",
"middle_name": "L",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "MA",
"license": "1894",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brockton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.