Richard Calvin Vangorden

Primary specialty

OpticianTaxonomy code 156FX1800X

License

009434 Issued in NY

Practice address

48 Main St
Massena, NY 13662-1984

Phone

(315) 764-7001

Fax

(315) 764-5615

NPI assigned

Dec 28, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1356652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356652800000",
    "number": "1992041628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 MAIN ST",
            "city": "MASSENA",
            "state": "NY",
            "postal_code": "136621984",
            "telephone_number": "315-764-7001",
            "fax_number": "315-764-5615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 MAIN ST",
            "city": "MASSENA",
            "state": "NY",
            "postal_code": "136621984",
            "telephone_number": "315-764-7001",
            "fax_number": "315-764-5615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANGORDEN",
        "first_name": "RICHARD",
        "middle_name": "CALVIN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-12-28",
        "last_updated": "2012-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NY",
            "license": "009434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optician in Massena, NY
• Providers in Massena, NY by specialty
• Optician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 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.