Active NPI
Wayne R Musselman, OD
- Optometrist
- Bellingham, WA
National Provider Identifier
1750419115
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1249TX
- Practice address
- 720 Birchwood Ave
Bellingham, WA 98225-1714 - Phone
- (360) 733-1720
- Fax
- (360) 733-0109
- NPI assigned
- Feb 28, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1249TX | WA | Primary |
Addresses
Primary practice location
720 Birchwood Ave
Bellingham, WA 98225-1714
Mailing address
PO Box 5566
Bellingham, WA 98227-5566
Phone (360) 733-1720
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DH0545 | Other | WA | RAILROAD MEDICARE |
| 2027688 | 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 |
|---|---|---|---|
| 1249TX | WA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1215475200000",
"number": "1750419115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5566",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "982275566",
"telephone_number": "360-733-1720",
"fax_number": "360-733-0109"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "720 BIRCHWOOD AVE",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "982251714",
"telephone_number": "360-733-1720",
"fax_number": "360-733-0109"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUSSELMAN",
"first_name": "WAYNE",
"middle_name": "R",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-28",
"last_updated": "2008-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WA",
"license": "1249TX",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "DH0545",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2027688",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bellingham, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.