Individual provider Active NPI

Richard C McClurg, OD

  • Optometrist
  • Canal Winchester, OH
National Provider Identifier
1972688190
Registry record updated Mar 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2710-T-557 Issued in OH
Practice address
20 S High St
Canal Winchester, OH 43110-1251
Phone
(614) 837-7725
Fax
(614) 837-7301
NPI assigned
Oct 26, 2006
Last updated
Mar 6, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2710-T-557 OH Primary

Addresses

Primary practice location

20 S High St
Canal Winchester, OH 43110-1251

Mailing address

20 S High St
Canal Winchester, OH 43110-1251
Phone (614) 837-7725

Other identifiers 1

IdentifierTypeStateIssuer
0030933MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20120509000047 OH Practitioner - Optometry 1759302185 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2710-T-557OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Richard C McClurg, OD & William Murray, OD LLC Optometrist CurrentSince Jan 1, 1991 Accepting new patients

Locations

6335 Winchester Blvd
Ste D
Canal Winchester, OH 43110
Phone (614) 837-7725

20 S High St
Canal Wnchstr, OH 43110
Phone (614) 837-7725

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, 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": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394064000000",
    "number": "1972688190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 S HIGH ST",
            "city": "CANAL WINCHESTER",
            "state": "OH",
            "postal_code": "431101251",
            "telephone_number": "614-837-7725",
            "fax_number": "614-837-7301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 S HIGH ST",
            "city": "CANAL WINCHESTER",
            "state": "OH",
            "postal_code": "431101251",
            "telephone_number": "614-837-7725",
            "fax_number": "614-837-7301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLURG",
        "first_name": "RICHARD",
        "middle_name": "C",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2014-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "2710-T-557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0030933",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canal Winchester, OH

Sources for this page

Verify at the official NPI Registry.