Individual provider Active NPI

George William Richter Jr., OD

  • Optometrist
  • Canfield, OH
National Provider Identifier
1689732430
Registry record updated Jan 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3887 Issued in OH
Practice address
450 E Main St
Doctors Park
Canfield, OH 44406-1581
Phone
(330) 533-5333
Fax
(330) 533-4797
NPI assigned
Dec 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3887 OH Primary

Addresses

Primary practice location

450 E Main St
Doctors Park
Canfield, OH 44406-1581

Mailing address

450 E Main St
Doctors Park
Canfield, OH 44406-1581
Phone (330) 533-5333

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120323000351 OH Practitioner - Optometry 8820100852 Practice locations: Canfield, OH

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

450 E Main St
Canfield, OH 44406-1581
Phone (330) 533-5333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3887OHMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359504000000",
    "number": "1689732430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 E MAIN ST",
            "address_2": "DOCTORS PARK",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444061581",
            "telephone_number": "330-533-5333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 E MAIN ST",
            "address_2": "DOCTORS PARK",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444061581",
            "telephone_number": "330-533-5333",
            "fax_number": "330-533-4797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHTER",
        "first_name": "GEORGE",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2013-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canfield, OH

Sources for this page

Verify at the official NPI Registry.