Active NPI
Willette King, O.D.
- Optometrist
- Stoneham, MA
National Provider Identifier
1760517270
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4610
- Practice address
- 196A Main St
Stoneham, MA 02180-1619 - Phone
- (781) 438-0290
- NPI assigned
- Feb 23, 2007
- Sex
- Female
- 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 | 4610 | MA | Primary |
Addresses
Primary practice location
196A Main St
Stoneham, MA 02180-1619
Mailing address
5 Pine St
Apt B
Boston, MA 02111-1424
Phone (617) 306-1703
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4610 | MA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1760517270",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 PINE ST",
"address_2": "APT B",
"city": "BOSTON",
"state": "MA",
"postal_code": "021111424",
"telephone_number": "617-306-1703"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "196A MAIN ST",
"city": "STONEHAM",
"state": "MA",
"postal_code": "021801619",
"telephone_number": "781-438-0290"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "WILLETTE",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MA",
"license": "4610",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stoneham, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.