MR. WILFRED JAMES FENNEWALD LICENSED OPTICIAN NPI 1093790941

NPI Information

NPI: 1093790941
Provider Name: MR. WILFRED JAMES FENNEWALD, LICENSED OPTICIAN
Classification: Technician/Technologist - 156FX1800X
Entity Type: Individual

Specialization: Optician

Address:
2737 NAVARRE AVE STE 204
OREGON, OH
ZIP 43616
Phone: (419) 693-3376
Get Directions

MR. Wilfred James Fennewald, LICENSED OPTICIAN is an optician technician technologist in Oregon, OH. The provider is opticians help fit eyeglasses and contact lenses, following prescriptions from Ophthalmologists and Optometrists. They also help customers decide which eyeglass frame or contact lenses to buy. MR. Wilfred James Fennewald, LICENSED OPTICIAN NPI is 1093790941. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2737 NAVARRE AVE STE 204
OREGON, OH
ZIP 43616-276
Phone: (419) 693-3376
Fax: (419) 693-7519

The enumeration date for this NPI number is 12/14/2005 and was last updated on 1/28/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	156FC0801X	Technician/Technologist	Contact Lens Fitter	SC2077	OHIO	No
2	156FX1800X	Technician/Technologist	Optician	SC2077	OHIO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0511637	MEDICAID	OHIO
2	363492	OTHER	OHIO	NVA
3	000000155056	OTHER	OHIO	ANTHEM
4	15295	OTHER	OHIO	SPECTERA
5	31106091100	OTHER	OHIO	BWC
6	OH2077	OTHER	OHIO	EYEMED
7	10251	OTHER	OHIO	PARAMOUNT HEALTH CARE
8	311060911001	OTHER	OHIO	MEDICAL MUTUAL

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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