John R Prewett, OD Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT 7312 TLG Issued in CA

Legal business name

JOHN R PREWETT, OD INC

Practice address

943 W Grand Ave
Grover Beach, CA 93433-2135

Phone

(805) 489-2020

NPI assigned

Feb 11, 2008

Organization subpart

Yes

Parent organization

VISION CENTER OF SANTA MARIAAs reported in NPPES

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

Authorized official

Name

Dr. John Rader Prewett, OD

Title

Owner

Phone

(805) 489-2020

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• John R Prewett O D Inc

  • Optometrist
  • Santa Maria, CA
  • NPI 1548308489

  O20101030000165

  Same enrollment

Part of

John R Prewett OD Inc

Locations

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

{
    "created_epoch": "1202688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202688000000",
    "number": "1720256993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "943 W GRAND AVE",
            "city": "GROVER BEACH",
            "state": "CA",
            "postal_code": "934332135",
            "telephone_number": "805-489-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "943 W GRAND AVE",
            "city": "GROVER BEACH",
            "state": "CA",
            "postal_code": "934332135",
            "telephone_number": "805-489-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN R PREWETT, OD INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VISION CENTER OF SANTA MARIA",
        "enumeration_date": "2008-02-11",
        "last_updated": "2008-02-11",
        "status": "A",
        "authorized_official_last_name": "PREWETT",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "RADER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "805-489-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT 7312 TLG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0073120",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lucy Jacob, OTR/L, CHT, HTC
• Stephanie Jennings
• Valeree Jensen, PHARMD
• Camila Paz Jeria Saez, RPE LICENSE SLP
• Jerry Ack Yu Yu Dental Corporation
• Bryce Anthony Johnson, LMFT
• Tayor Joller
• Stanton C Jones, AU.D
• Emily Katnic
• Elizabeth Kelley

• Optometrist in Grover Beach, CA
• Providers in Grover Beach, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.