Individual provider Active NPI

John Arnold, OD

  • Optometrist
  • Fairfax, VA
National Provider Identifier
1932283207
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618000369 Issued in VA
Practice address
11903-I Lee Jackson Memorial Hwy
#G133
Fairfax, VA 22033
Phone
(703) 218-8036
Fax
(703) 218-9841
NPI assigned
Oct 24, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618000369 VA Primary

Addresses

Primary practice location

11903-I Lee Jackson Memorial Hwy
#G133
Fairfax, VA 22033

Mailing address

11103 West Ave
Suite 6
San Antonio, TX 78213-1370
Phone (210) 524-6509

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040526001368 DC Practitioner - Optometry 3476534371 Reassigns benefits to 1 organization
I20050201000119 MD Practitioner - Optometry 3476534371 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0618000369VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Visionworks Inc. Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932283207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11103 WEST AVE",
            "address_2": "SUITE 6",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782131370",
            "telephone_number": "210-524-6509",
            "fax_number": "210-524-6587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11903-I LEE JACKSON MEMORIAL HWY",
            "address_2": "#G133",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "22033",
            "telephone_number": "703-218-8036",
            "fax_number": "703-218-9841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARNOLD",
        "first_name": "JOHN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618000369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.