Individual provider Active NPI

William C Rich Jr., OPTICIAN

  • Optician
  • Dryden, NY
National Provider Identifier
1790057586
Registry record updated Feb 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
005512-1 Issued in NY
Practice address
88 North St
Dryden, NY 13053-8500
Phone
(607) 844-9477
Fax
(607) 844-9478
NPI assigned
Feb 8, 2012
Last updated
Feb 8, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 005512-1 NY Primary

Addresses

Primary practice location

88 North St
Dryden, NY 13053-8500

Mailing address

88 North St
Dryden, NY 13053-8500

Other identifiers 1

IdentifierTypeStateIssuer
02164496MedicaidNY

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

LicenseStateTypeSpecialty
005512-1NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
William C Rich Jr Past Accepting new patients
Dryden Optometry P.C. PastSince Jun 24, 2013 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1328659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328659200000",
    "number": "1790057586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 NORTH ST",
            "city": "DRYDEN",
            "state": "NY",
            "postal_code": "130538500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 NORTH ST",
            "city": "DRYDEN",
            "state": "NY",
            "postal_code": "130538500",
            "telephone_number": "607-844-9477",
            "fax_number": "607-844-9478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICH",
        "first_name": "WILLIAM",
        "middle_name": "C",
        "name_suffix": "Jr.",
        "credential": "OPTICIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-08",
        "last_updated": "2012-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NY",
            "license": "005512-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02164496",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dryden, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2012; 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.