Active NPI
John A Zieg, O.D.
- Optometrist
- Canby, OR
National Provider Identifier
1720158348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1739ATI
- Practice address
- 310 NW 3Rd Ave
Canby, OR 97013-3603 - Phone
- (503) 266-6600
- Fax
- (503) 266-6875
- NPI assigned
- Nov 9, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1739ATI | OR | Primary |
Addresses
Primary practice location
310 NW 3Rd Ave
Canby, OR 97013-3603
Mailing address
310 NW 3Rd Ave
Canby, OR 97013-3603
Phone (503) 266-6600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004213 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1739ATI | OR | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352073600000",
"number": "1720158348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "310 NW 3RD AVE",
"city": "CANBY",
"state": "OR",
"postal_code": "970133603",
"telephone_number": "503-266-6600",
"fax_number": "503-266-6875"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "310 NW 3RD AVE",
"city": "CANBY",
"state": "OR",
"postal_code": "970133603",
"telephone_number": "503-266-6600",
"fax_number": "503-266-6875"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZIEG",
"first_name": "JOHN",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-09",
"last_updated": "2012-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OR",
"license": "1739ATI",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004213",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Canby, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.