Active NPI
James D. Studebaker, OD
- Optometrist
- Englewood, OH
National Provider Identifier
1982608261
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2744
- Practice address
- 639 W National Rd
Englewood, OH 45322-1155 - Phone
- (937) 836-3041
- Fax
- (937) 836-1937
- NPI assigned
- Jun 2, 2005
- 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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2744 | OH | Primary |
Addresses
Primary practice location
639 W National Rd
Englewood, OH 45322-1155
Mailing address
639 W National Rd
Englewood, OH 45322-1155
Phone (937) 836-3041
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8542492 | Medicaid | OH |
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 |
|---|---|---|---|
| 2744 | OH | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dickman Kettler & Bruner Inc | Optometrist | 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.
-
- Optometrist
- Coldwater, OH
- NPI 1558478453
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1982608261",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "639 W NATIONAL RD",
"city": "ENGLEWOOD",
"state": "OH",
"postal_code": "453221155",
"telephone_number": "937-836-3041",
"fax_number": "937-836-1937"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "639 W NATIONAL RD",
"city": "ENGLEWOOD",
"state": "OH",
"postal_code": "453221155",
"telephone_number": "937-836-3041",
"fax_number": "937-836-1937"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STUDEBAKER",
"first_name": "JAMES",
"middle_name": "D.",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OH",
"license": "2744",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8542492",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Englewood, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.