Mitchell Lee Koerber, OD

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

WV937OD Issued in WV

Practice address

442 Highland Ave
Williamstown, WV 26187-1249

Phone

(304) 375-6468

Fax

(304) 375-6468

NPI assigned

Apr 18, 2006

Last updated

Mar 12, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Optometry

Education

Southern College of Optometry, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optometric Physicians of Parkersburg IncGroup PAC ID 1153372784, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Optometric Physicians of Parkersburg Inc

  • Corneal and Contact Management Optometrist
  • Parkersburg, WV
  • NPI 1659459592
  Medicare reassignment Care Compare group NPD
• Williamstown Eye Clinic Inc.

  • Optometrist
  • Williamstown, WV
  • NPI 1013121680
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268352000000",
    "number": "1801851316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "442 HIGHLAND AVE",
            "city": "WILLIAMSTOWN",
            "state": "WV",
            "postal_code": "261871299",
            "telephone_number": "304-375-6468",
            "fax_number": "304-375-6468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "442 HIGHLAND AVE",
            "city": "WILLIAMSTOWN",
            "state": "WV",
            "postal_code": "261871249",
            "telephone_number": "304-375-6468",
            "fax_number": "304-375-6468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOERBER",
        "first_name": "MITCHELL",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2010-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "WV",
            "license": "WV937OD",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0149872000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Crystal Kingry
• Michelle Lea Kirkpatrick
• Brittany M Klug
• Agnes Louise Knopp
• Mary Knowlton
• Molly Lamone
• Jeremy Todd Leichliter
• Lincare Inc.
• Linx Community Service, LLC
• Linx Community Service, LLC

• Corneal and Contact Management Optometrist in Williamstown, WV
• Providers in Williamstown, WV by specialty
• Corneal and Contact Management Optometrist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.