Active NPI
Regional Eye Associates, Inc.
- Ophthalmology Physician
- Bridgeport, WV
National Provider Identifier
1801066410
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- Legal business name
- REGIONAL EYE ASSOCIATES, INC.
- Practice address
- 110 Cambridge PL
Bridgeport, WV 26330-2812 - Phone
- (304) 842-4070
- Fax
- (304) 599-7346
- NPI assigned
- Mar 11, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Stephen R Powell, M.D.
- Title
- President
- Phone
- (304) 598-3301
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | Primary |
Addresses
Primary practice location
110 Cambridge PL
Bridgeport, WV 26330-2812
Mailing address
1255 Pineview Dr
Morgantown, WV 26505-2713
Phone (304) 598-3301
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0007123000 | Medicaid | WV |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WV
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040211001115 | WV | Part B Supplier - Clinic/Group Practice | 1456255876 |
Receives reassigned benefits from 18 practitioners 5 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Bridgeport, WV; Morgantown, WV; Weston, WV |
Other NPIs on the same Medicare enrollment 5
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryLocations
220 Southview Dr
Bridgeport, WV 26330
Phone (304) 598-3301
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205193600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1205193600000",
"number": "1801066410",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1255 PINEVIEW DR",
"city": "MORGANTOWN",
"state": "WV",
"postal_code": "265052713",
"telephone_number": "304-598-3301",
"fax_number": "304-599-7346"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 CAMBRIDGE PL",
"city": "BRIDGEPORT",
"state": "WV",
"postal_code": "263302812",
"telephone_number": "304-842-4070",
"fax_number": "304-599-7346"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "REGIONAL EYE ASSOCIATES, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2008-03-11",
"last_updated": "2008-03-11",
"status": "A",
"authorized_official_last_name": "POWELL",
"authorized_official_first_name": "STEPHEN",
"authorized_official_middle_name": "R",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "304-598-3301",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Ophthalmology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0007123000",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bridgeport, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 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.