NPIMap

Organization Active NPI

Joshua Driver PC

  • Optometrist
  • Opp, AL
National Provider Identifier
1770616989
Registry record updated Nov 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
JOSHUA DRIVER PC
Practice address
604 N Main St Ste a
Opp, AL 36467-1600
Phone
(334) 493-6600
Fax
(334) 493-2991
NPI assigned
Mar 14, 2007
Last updated
Nov 5, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2014

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

Authorized official

Name
Joshua Driver, PCNPI 1972679033
Title
Doctor
Phone
(334) 493-6600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

604 N Main St Ste a
Opp, AL 36467-1600

Mailing address

604 N Main St Ste a
Opp, AL 36467-1600
Phone (334) 493-6600

Other identifiers 1

IdentifierTypeStateIssuer
529912170MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930100701 AL DME Supplier - Physician - Optometrist 1557486727 Practice locations: Opp, AL
O20141113000885 AL Part B Supplier - Clinic/Group Practice 1557486727 Receives reassigned benefits from 3 practitioners
Practice locations: Florala, AL; Elba, AL; Opp, AL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Joshua Driver PC604 N Main St, Opp, AL 36467-1600(334) 493-6600 Prosthetic Lenses: Conventional Eyeglasses Accepts assignmentParticipating since Sep 3, 2002

National Provider Directory

National Provider Directory
Tax ID family
Joshua Driver PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

961 Alabama Highway 203
Elba, AL 36323
Phone (334) 897-2142

23542 5th Ave
Florala, AL 36442
Phone (334) 897-2142

604 N Main St
Opp, AL 36467
Phone (334) 493-6600

604 N Main St
Ste A
Opp, AL 36467
Phone (334) 479-0043

Practitioners & affiliated clinicians

Practitioners 5

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": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415145600000",
    "number": "1770616989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 N MAIN ST STE A",
            "city": "OPP",
            "state": "AL",
            "postal_code": "364671600",
            "telephone_number": "334-493-6600",
            "fax_number": "334-493-2991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 N MAIN ST STE A",
            "city": "OPP",
            "state": "AL",
            "postal_code": "364671600",
            "telephone_number": "334-493-6600",
            "fax_number": "334-493-2991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSHUA DRIVER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2014-11-05",
        "status": "A",
        "authorized_official_last_name": "DRIVER",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "334-493-6600",
        "authorized_official_credential": "PC"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529912170",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Opp, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.