Individual provider Active NPI

Katie Palmer, OD

  • Optometrist
  • Vienna, WV
National Provider Identifier
1801374269
Registry record updated Jul 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2049-IOD Issued in WV
Practice address
1600 Grand Central Ave
Vienna, WV 26105-1059
Phone
(304) 295-8561
NPI assigned
Jul 29, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2049-IOD WV Primary

Addresses

Primary practice location

1600 Grand Central Ave
Vienna, WV 26105-1059

Mailing address

4301 10TH Ave
Vienna, WV 26105-2917
Phone (304) 650-4304

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181115001208 WV Practitioner - Optometry 2961756630 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Visionary Eye Clinic PLLCGroup PAC ID 7012439318, 3 clinicians

Practice addresses (Care Compare)

1600 Grand Central Ave
Vienna, WV 26105-1059
Phone (304) 295-8561

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
R Joe Weaver OD Optometrist CurrentSince Aug 1, 2018 Accepting new patients
Visionary Eye Clinic PLLC Optometrist CurrentSince Feb 5, 2025 Accepting new patients

Locations

1600 Grand Central Ave
Vienna, WV 26105
Phone (304) 295-8561

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1532822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532822400000",
    "number": "1801374269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 10TH AVE",
            "city": "VIENNA",
            "state": "WV",
            "postal_code": "261052917",
            "telephone_number": "304-650-4304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 GRAND CENTRAL AVE",
            "city": "VIENNA",
            "state": "WV",
            "postal_code": "261051059",
            "telephone_number": "304-295-8561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "KATIE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-29",
        "last_updated": "2018-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WV",
            "license": "2049-IOD",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vienna, WV

Sources for this page

Verify at the official NPI Registry.