Individual provider Active NPI

John Charles Downing, OD PHD

  • Optometrist
  • Sebastopol, CA
National Provider Identifier
1679639983
Registry record updated Feb 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT4981TPA Issued in CA
Practice address
720 Grandview Rd
Sebastopol, CA 95472-2901
Phone
(707) 829-1478
Fax
(707) 829-3444
NPI assigned
Dec 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT4981TPA CA Primary

Addresses

Primary practice location

720 Grandview Rd
Sebastopol, CA 95472-2901

Mailing address

720 Grandview Rd
Sebastopol, CA 95472-2901
Phone (707) 829-1478

Other identifiers 2

IdentifierTypeStateIssuer
9841OtherPIN
0049810MedicaidCA

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 Philosophy

State licenses

LicenseStateTypeSpecialty
OPT4981TPACAMDOptometrist

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": "1234742400000",
    "number": "1679639983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 GRANDVIEW RD",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954722901",
            "telephone_number": "707-829-1478",
            "fax_number": "707-829-3444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 GRANDVIEW RD",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954722901",
            "telephone_number": "707-829-1478",
            "fax_number": "707-829-3444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOWNING",
        "first_name": "JOHN",
        "middle_name": "CHARLES",
        "credential": "OD PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-29",
        "last_updated": "2009-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT4981TPA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PIN",
            "identifier": "9841",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0049810",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebastopol, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2009; 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.