Angotti Family Eyecare PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

990-OD Issued in WV

Legal business name

ANGOTTI FAMILY EYECARE PLLC

Practice address

120 Medical Park Dr
Suite 104
Bridgeport, WV 26330-9012

Phone

(304) 842-4000

Fax

(304) 842-8002

NPI assigned

Oct 29, 2014

Organization subpart

No

Name

Dr. Lori Angotti, O.D.NPI 1962520387

Title

Owner

Phone

(304) 629-6859

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lori Michele Angotti, O.D.

  • Optometrist
  • Bridgeport, WV
  • NPI 1962520387
  Medicare reassignment NPD Authorized official
• Matthew Glen Berardi, OD

  • Optometrist
  • Farmington, WV
  • NPI 1417022773
  NPD (past)

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 18, 2014.

{
    "created_epoch": "1414540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416268800000",
    "number": "1871998047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 MEDICAL PARK DR",
            "address_2": "SUITE 104",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263309012",
            "telephone_number": "304-842-4000",
            "fax_number": "304-842-8002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 MEDICAL PARK DR",
            "address_2": "SUITE 104",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263309012",
            "telephone_number": "304-842-4000",
            "fax_number": "304-842-8002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGOTTI FAMILY EYECARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-29",
        "last_updated": "2014-11-18",
        "status": "A",
        "authorized_official_last_name": "ANGOTTI",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-629-6859",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WV",
            "license": "990-OD",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beth Anne Amos, CRNA
• Anatomical Designs, Inc.
• Alexis Anders, M.S., CCC-SLP
• Ava Anderson, MOT
• Corey Anderson, DDS
• Frank Thomas Angotti III, M.D.
• John David Angotti, MD
• Lori Michele Angotti, O.D.
• Michael T. Angotti, MD
• Applegate Health Services, Inc

• All providers in Bridgeport, WV
• Optometrist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2014; 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.

Verify at the official NPI Registry.