NPIMap

Organization Active NPI

Mervin W Stoltzfus OD

  • Optometrist
  • Christiana, PA
National Provider Identifier
1720020019
Registry record updated Apr 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG001396 Issued in PA
Legal business name
MERVIN W STOLTZFUS OD
Practice address
316 Newport Ave
Christiana, PA 17509-1312
Phone
(610) 593-6670
NPI assigned
Jun 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2008

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

Authorized official

Name
Dr. Mervin W StoltzfusNPI 1669497889
Title
Owner
Phone
(610) 593-6670

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OEG001396 PA Primary

Addresses

Primary practice location

316 Newport Ave
Christiana, PA 17509-1312

Mailing address

PO Box 75
Christiana, PA 17509
Phone (610) 593-6670

Other identifiers 1

IdentifierTypeStateIssuer
0546535MedicaidPA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207267200000",
    "number": "1720020019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 75",
            "city": "CHRISTIANA",
            "state": "PA",
            "postal_code": "17509",
            "telephone_number": "610-593-6670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 NEWPORT AVE",
            "city": "CHRISTIANA",
            "state": "PA",
            "postal_code": "175091312",
            "telephone_number": "610-593-6670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERVIN W STOLTZFUS OD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2008-04-04",
        "status": "A",
        "authorized_official_last_name": "STOLTZFUS",
        "authorized_official_first_name": "MERVIN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-593-6670",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG001396",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0546535",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Christiana, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2008; 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.