Individual provider Active NPI

James R Conway, OD

  • Optometrist
  • Millersburg, OH
National Provider Identifier
1891795365
Registry record updated Jun 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3528 T388 Issued in OH
Practice address
1275 Glen Dr
Millersburg, OH 44654-8958
Phone
(330) 674-6121
Fax
(330) 674-7409
NPI assigned
Jul 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3528 T388 OH Primary

Addresses

Primary practice location

1275 Glen Dr
Millersburg, OH 44654-8958

Mailing address

1275 Glen Dr
Millersburg, OH 44654-8958
Phone (330) 674-6121

Other identifiers 2

IdentifierTypeStateIssuer
34144150900OtherOHBWC
0468088MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1122422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213142400000",
    "number": "1891795365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 GLEN DR",
            "city": "MILLERSBURG",
            "state": "OH",
            "postal_code": "446548958",
            "telephone_number": "330-674-6121",
            "fax_number": "330-674-7409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 GLEN DR",
            "city": "MILLERSBURG",
            "state": "OH",
            "postal_code": "446548958",
            "telephone_number": "330-674-6121",
            "fax_number": "330-674-7409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONWAY",
        "first_name": "JAMES",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-27",
        "last_updated": "2008-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3528 T388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BWC",
            "identifier": "34144150900",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0468088",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Millersburg, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2008; 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.