Greenbrier Physicians, Inc. Optical Shop

Primary specialty

Ophthalmic Technician/TechnologistTaxonomy code 156FX1100X

Legal business name

GREENBRIER PHYSICIANS, INC. OPTICAL SHOP

Practice address

200 Maplewood Ave
Ronceverte, WV 24970-1334

Phone

(304) 647-1147

Fax

(304) 647-3006

NPI assigned

Jun 16, 2009

Last updated

Jun 16, 2009By the provider in NPPES

Organization subpart

Yes

Parent organization

GREENBRIER PHYSICIANS, INC.As reported in NPPES

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

Authorized official

Name

Mr. John D. Trout

Title

Clinic Administrator

Phone

(304) 647-1140

Specialties & licenses 5

Addresses

Tax ID family

Greenbrier Physicians I4 organizations share this tax ID, including this one

Part of

Greenbrier Physicians I

Other organizations with this tax ID 3

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

• Greenbrier Physicians Rural Health Clinic

  • Rural Health Clinic/Center
  • Ronceverte, WV
  • NPI 1952865255
  NPD tax ID
• Greenbrier Physicians, Inc

  • Darkroom Technician
  • Ronceverte, WV
  • NPI 1154442028
  NPD tax ID
• Greenbrier Physicians, Inc.

  • Clinical Medical Laboratory
  • Ronceverte, WV
  • NPI 1790806651
  NPD tax ID

Practitioners 1

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.

• Constance L. Anderson, D.O.

  • Family Medicine Physician
  • Ronceverte, WV
  • NPI 1043237613
  NPD (past)

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

{
    "created_epoch": "1245110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245110400000",
    "number": "1861629917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MAPLEWOOD AVE",
            "city": "RONCEVERTE",
            "state": "WV",
            "postal_code": "249701334",
            "telephone_number": "304-647-1147",
            "fax_number": "304-647-3006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MAPLEWOOD AVE",
            "city": "RONCEVERTE",
            "state": "WV",
            "postal_code": "249701334",
            "telephone_number": "304-647-1147",
            "fax_number": "304-647-3006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENBRIER PHYSICIANS, INC. OPTICAL SHOP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GREENBRIER PHYSICIANS, INC.",
        "enumeration_date": "2009-06-16",
        "last_updated": "2009-06-16",
        "status": "A",
        "authorized_official_last_name": "TROUT",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "CLINIC ADMINISTRATOR",
        "authorized_official_telephone_number": "304-647-1140",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "156F00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "156FC0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Contact Lens",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "156FC0801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Contact Lens Fitter",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "156FX1100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Ophthalmic",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "156FX1101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Ophthalmic Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Greenbrier County Board of Health
• Greenbrier Physicians Rural Health Clinic
• Greenbrier Physicians, Inc
• Greenbrier Physicians, Inc
• Greenbrier Physicians, Inc.
• Greenbrier Valley Anesthesia LLC
• Greenbrier Valley Emergency Physicians LLC
• Greenbrier Valley ENT PLLC
• Greenbrier Valley Physical Therapy, LLC
• Greenbrier Valley Urology Associates, Inc

• Ophthalmic Technician/Technologist in Ronceverte, WV
• Providers in Ronceverte, WV by specialty
• Ophthalmic Technician/Technologist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2009; 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.