NPIMap

Organization Active NPI

Robert F. Dibble

  • Ophthalmology Physician
  • Willimantic, CT
National Provider Identifier
1720178577
Registry record updated Jun 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
030376 Issued in CT
Legal business name
ROBERT F. DIBBLE
Practice address
1120 Main St
Willimantic, CT 06226-2014
Phone
(860) 423-2111
Fax
(860) 423-7559
NPI assigned
Oct 13, 2006
Last updated
Jun 11, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2015

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

Authorized official

Name
Dr. Robert F Dibble, M.D.NPI 1902835556
Title
Owner
Phone
(860) 423-2111

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X 002357 CT
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X 002698 CT
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X 030376 CT Primary

Addresses

Primary practice location

1120 Main St
Willimantic, CT 06226-2014

Mailing address

1120 Main St
Willimantic, CT 06226-2014
Phone (860) 423-2111

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433980800000",
    "number": "1720178577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 MAIN ST",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062262014",
            "telephone_number": "860-423-2111",
            "fax_number": "860-423-7559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 MAIN ST",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062262014",
            "telephone_number": "860-423-2111",
            "fax_number": "860-423-7559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT F. DIBBLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2015-06-11",
        "status": "A",
        "authorized_official_last_name": "DIBBLE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-423-2111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "CT",
            "license": "002357",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "CT",
            "license": "002698",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "CT",
            "license": "030376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willimantic, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2015; 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.