NPIMap

Organization Active NPI

Allegany Optical LLC

Doing business as Allegany Optical

  • Optometrist
  • Charles Town, WV
National Provider Identifier
1952582207
Registry record updated Aug 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1045-5379 Issued in WV
Legal business name
ALLEGANY OPTICAL LLC
Doing business as
Allegany Optical
Practice address
838 Somerset Blvd
Charles Town, WV 25414-5625
Phone
(304) 725-4828
Fax
(304) 725-4217
NPI assigned
Nov 15, 2007
Last updated
Aug 16, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2012

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

Authorized official

Name
Dr. Patrick M Fleming, O.D.NPI 1336224542
Title
O.D. / Managing Member
Phone
(304) 267-9911

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1045-5379 WV Primary

Addresses

Primary practice location

838 Somerset Blvd
Charles Town, WV 25414-5625

Mailing address

838 Somerset Blvd
Charles Town, WV 25414-5625
Phone (304) 725-4828

Other identifiers 2

IdentifierTypeStateIssuer
0201708000MedicaidWV
CH4518OtherWVRAILROAD MEDICARE

Other names 1

  • ALLEGANY OPTICAL Doing business as

National Provider Directory

National Provider Directory

Locations

838 Somerset Blvd
Charles Town, WV 25414
Phone (304) 725-4828

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1195084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345075200000",
    "number": "1952582207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "838 SOMERSET BLVD",
            "city": "CHARLES TOWN",
            "state": "WV",
            "postal_code": "254145625",
            "telephone_number": "304-725-4828",
            "fax_number": "304-725-4217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "838 SOMERSET BLVD",
            "city": "CHARLES TOWN",
            "state": "WV",
            "postal_code": "254145625",
            "telephone_number": "304-725-4828",
            "fax_number": "304-725-4217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLEGANY OPTICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-15",
        "last_updated": "2012-08-16",
        "status": "A",
        "authorized_official_last_name": "FLEMING",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "O.D. / MANAGING MEMBER",
        "authorized_official_telephone_number": "304-267-9911",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WV",
            "license": "1045-5379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0201708000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CH4518",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ALLEGANY OPTICAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charles Town, WV

Sources for this page

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

Verify at the official NPI Registry.