Active NPI
David R. Vera Sr., CO
- Orthotist
- Lodi, CA
National Provider Identifier
1942445440
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthotist
- License
- CO003590
- Practice address
- 1300 W Lodi Ave
Suite H
Lodi, CA 95242-3000 - Phone
- (209) 625-8450
- Fax
- (209) 224-8416
- NPI assigned
- Dec 11, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthotist | 222Z00000X | CO003590 | CA | Primary |
Addresses
Primary practice location
1300 W Lodi Ave
Suite H
Lodi, CA 95242-3000
Mailing address
1300 W Lodi Ave
Suite H
Lodi, CA 95242-3000
Phone (209) 625-8450
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CO003590 | CA | MD | Orthotist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Preferred Prosthetics Inc | Orthotist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351814400000",
"number": "1942445440",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1300 W LODI AVE",
"address_2": "SUITE H",
"city": "LODI",
"state": "CA",
"postal_code": "952423000",
"telephone_number": "209-625-8450",
"fax_number": "209-224-8416"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 W LODI AVE",
"address_2": "SUITE H",
"city": "LODI",
"state": "CA",
"postal_code": "952423000",
"telephone_number": "209-625-8450",
"fax_number": "209-224-8416"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VERA",
"first_name": "DAVID",
"middle_name": "R.",
"name_suffix": "Sr.",
"credential": "CO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-12-11",
"last_updated": "2012-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "222Z00000X",
"taxonomy_group": "",
"desc": "Orthotist",
"state": "CA",
"license": "CO003590",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lodi, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.