Individual provider Active NPI

Andrea L Murphy, OD, FAAO

  • Optometrist
  • White River Junction, VT
National Provider Identifier
1689830929
Registry record updated Jun 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
030-0000351 Issued in VT
Practice address
215 North Main Street, Desk 100 (112)
Department of Veteran Affairs
White River Junction, VT 05009
Phone
(802) 295-9363
Fax
(802) 296-5112
NPI assigned
Aug 6, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 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 030-0000351 VT Primary

Addresses

Primary practice location

215 North Main Street, Desk 100 (112)
Department of Veteran Affairs
White River Junction, VT 05009

Mailing address

215 North Main Street, Desk 100 (112)
Department of Veteran Affairs
White River Junction, VT 05009
Phone (802) 295-9363

Other identifiers 2

IdentifierTypeStateIssuer
OVN1861MedicaidVT
30210240MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
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
I20210722003460 VT Order and Referring Only - OptometryPractitioner - Optometry 4789087115

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3287TNMDDentist
030-0000351VTMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1217980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372291200000",
    "number": "1689830929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 NORTH MAIN STREET, DESK 100 (112)",
            "address_2": "DEPARTMENT OF VETERAN AFFAIRS",
            "city": "WHITE RIVER JUNCTION",
            "state": "VT",
            "postal_code": "05009",
            "telephone_number": "802-295-9363",
            "fax_number": "802-296-5112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 NORTH MAIN STREET, DESK 100 (112)",
            "address_2": "DEPARTMENT OF VETERAN AFFAIRS",
            "city": "WHITE RIVER JUNCTION",
            "state": "VT",
            "postal_code": "05009",
            "telephone_number": "802-295-9363",
            "fax_number": "802-296-5112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURPHY",
        "first_name": "ANDREA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "OD, FAAO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-06",
        "last_updated": "2013-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VT",
            "license": "030-0000351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OVN1861",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30210240",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in White River Junction, VT

Sources for this page

Verify at the official NPI Registry.