Active NPI
John C Stoddard, O.D.
- Optometrist
- Chehalis, WA
National Provider Identifier
1699874420
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OD00001851
- Practice address
- 1179 S Market Blvd
Chehalis, WA 98532-3427 - Phone
- (360) 748-9228
- Fax
- (360) 748-4617
- NPI assigned
- Sep 21, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Optometrist | 152WP0200X | OD00001851 | WA | |
| Optometrist | 152W00000X | OD00001851 | WA | Primary |
Addresses
Primary practice location
1179 S Market Blvd
Chehalis, WA 98532-3427
Mailing address
PO Box 1126
Chehalis, WA 98532-0169
Phone (360) 748-9228
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| HE7836 | Other | WA | REGENCE CLINIC NUMBER |
| ST3361 | Other | WA | REGENCE JCSTODDARD |
| 0056033 | Other | WA | L&I JCSTODDARD ONLY |
| 0036580 | Other | WA | L&I CLINIC GROUP |
| 2046506 | Medicaid | WA | |
| 2011716 | Medicaid | WA |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OD00001851 | WA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357171200000",
"number": "1699874420",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1126",
"city": "CHEHALIS",
"state": "WA",
"postal_code": "985320169",
"telephone_number": "360-748-9228",
"fax_number": "360-748-4617"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1179 S MARKET BLVD",
"city": "CHEHALIS",
"state": "WA",
"postal_code": "985323427",
"telephone_number": "360-748-9228",
"fax_number": "360-748-4617"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STODDARD",
"first_name": "JOHN",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-21",
"last_updated": "2013-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "152WP0200X",
"taxonomy_group": "",
"desc": "Optometrist, Pediatrics",
"state": "WA",
"license": "OD00001851",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WA",
"license": "OD00001851",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE CLINIC NUMBER",
"identifier": "HE7836",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE JCSTODDARD",
"identifier": "ST3361",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I JCSTODDARD ONLY",
"identifier": "0056033",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I CLINIC GROUP",
"identifier": "0036580",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2046506",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2011716",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chehalis, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.