Active NPI
Earl Tobias Myers, O.D.
- Optometrist
- Willits, CA
National Provider Identifier
1962582825
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 6519T
- Practice address
- 98 W Commercial St
Willits, CA 95490-3007 - Phone
- (707) 459-4703
- NPI assigned
- Oct 16, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 6519T | CA | Primary |
Addresses
Primary practice location
98 W Commercial St
Willits, CA 95490-3007
Mailing address
98 W Commercial St
Willits, CA 95490-3007
Phone (707) 459-4703
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SD0065190 | Medicaid | CA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6519T | CA | MD | Optometrist |
| 6519 | CA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201737600000",
"number": "1962582825",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "98 W COMMERCIAL ST",
"city": "WILLITS",
"state": "CA",
"postal_code": "954903007",
"telephone_number": "707-459-4703"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "98 W COMMERCIAL ST",
"city": "WILLITS",
"state": "CA",
"postal_code": "954903007",
"telephone_number": "707-459-4703"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MYERS",
"first_name": "EARL",
"middle_name": "TOBIAS",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-16",
"last_updated": "2008-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "6519T",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SD0065190",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Willits, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.