Organization Active NPI

Dr. Robert Schorn Purnell LLC

  • Optometrist
  • Rutherford, NJ
National Provider Identifier
1972756757
Registry record updated May 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OM00041400 Issued in NJ
Legal business name
DR. ROBERT SCHORN PURNELL LLC
Practice address
31 Park Ave
Rutherford, NJ 07070-1711
Phone
(201) 939-2463
Fax
(201) 939-1454
NPI assigned
Oct 24, 2008
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Dr. Robert Schorn Purnell, ODNPI 1427000389
Title
Owner/Dr
Phone
(201) 939-2463

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130520000023 NJ Part B Supplier - Clinic/Group Practice 7113164757 Receives reassigned benefits from 3 practitioners
Practice locations: Rutherford, NJ

National Provider Directory

National Provider Directory

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 27OM00041400 NJ Primary

Addresses

NPPES NPI Registry

Primary practice location

31 Park Ave
Rutherford, NJ 07070-1711

Mailing address

31 Park Ave
Rutherford, NJ 07070-1711
Phone (201) 939-2463

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
1815202MedicaidNJ
7714106MedicaidNJ

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 9, 2013.

{
    "created_epoch": "1224806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368057600000",
    "number": "1972756757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 PARK AVE",
            "city": "RUTHERFORD",
            "state": "NJ",
            "postal_code": "070701711",
            "telephone_number": "201-939-2463",
            "fax_number": "201-939-1454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 PARK AVE",
            "city": "RUTHERFORD",
            "state": "NJ",
            "postal_code": "070701711",
            "telephone_number": "201-939-2463",
            "fax_number": "201-939-1454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. ROBERT SCHORN PURNELL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-24",
        "last_updated": "2013-05-09",
        "status": "A",
        "authorized_official_last_name": "PURNELL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "SCHORN",
        "authorized_official_title_or_position": "OWNER/DR",
        "authorized_official_telephone_number": "201-939-2463",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OM00041400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1815202",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7714106",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rutherford, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.