BARRY ANDREW CLEGG (NPI# 1578625612) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578625612 |
| Entity Type | Individual |
| Full Name | BARRY ANDREW CLEGG |
| Other Name | ANDREW CLEGG |
| Credential | O.D. |
| Practice Address |
2352 Poplar Dr Medford OR 97504-5297 |
| Mailing Address |
Po Box 1555 Jacksonville OR 97530-1555 |
| Practice Telephone | 5417722895 |
| Practice Fax Number | 5417720531 |
| Mailing Telephone | 5417722895 |
| Mailing Fax Number | 5417720531 |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152W00000X | Optometrist | 620 | MT | Eye and Vision Services Providers |
| Y | 152W00000X | Optometrist | 2531T | OR | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 075965 | 05 |
| Street Address |
2352 POPLAR DR |
| City | MEDFORD |
| State | OR |
| Zip Code | 97504-5297 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821295023 | Shandell Wingler | Technician/Technologist | 2352 Poplar Dr, Medford, OR 97504-5297 | 2007-06-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225673833 | Lydia D Sneed | Behavioral Analyst | 3707 Citation Way, Suite 102, Medford, OR 97504 | 2019-11-07 |
| 1114577368 | Heather Ashley Fronek | Nurse Practitioner | 2825 E. Barnett Rd., Medford, OR 97504 | 2019-09-18 |
| 1255809109 | Justin Blasdel | Technician, Health Information | 3250 Lone Pine Rd, Medford, OR 97504 | 2018-11-08 |
| 1396220133 | Aimee K Michel | Massage Therapist | 3550 National Dr., Medford, OR 97504 | 2018-09-27 |
| 1437646908 | Zola Dental Medford LLC | Dentist | 922 E Main, Medford, OR 97504 | 2018-04-19 |
| 1376068015 | Megan Leggett | Counselor | 777 Murphy Road, Medford, OR 97504 | 2017-08-03 |
| 1023547536 | Joshua Morgan Rice | Dentist | 1117 E Main St Ste 1, Medford, OR 97504 | 2017-06-08 |
| 1427580232 | Paul James Dean | Counselor | 1175 Main St Ste 1c, Medford, OR 97504 | 2017-03-30 |
| 1811443542 | Taya Adams | Doula | 1201 Progress Dr #90, Medford, OR 97504 | 2016-09-01 |
| 1174076228 | Avalon Health Care - Hearthstone, LLC | Skilled Nursing Facility | 2091 E. Barnett Road, Medford, OR 97504 | 2016-07-25 |
| Find all providers in zip 97504 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417339359 | Angela Marie Dedionisio | Optometrist | 38 Rossanley Dr, Medford, OR 97501 | 2015-06-28 |
| 1508243239 | Bastian Eyecare Professionals | Optometrist | 12 Revere Pl, Medford, MA 02155-3903 | 2015-05-01 |
| 1700216090 | All Eye Care At Davis, Inc | Optometrist | 63 Station Lndg, Att. Dr Dzenana Idrizovic, Medford, MA 02155-5192 | 2013-11-22 |
| 1518246883 | Yan Lu | Optometrist | 278 Middlesex Ave, Medford, MA 02155-5066 | 2011-08-04 |
| 1821307182 | Diane Marie Shaver | Optometrist | 1600 N Riverside Ave Unit 2027, Medford, OR 97501-4665 | 2010-10-04 |
| 1659491777 | Stephen Allen Barnes | Optometrist | 3639 Crater Lake Hwy, Medford, OR 97504-9259 | 2007-03-30 |
| 1700916251 | Wayne Leroy Knight | Optometrist | 120 Route 70, Medford, NJ 08055-9504 | 2007-03-06 |
| 1477692655 | Kimberly Tischner | Optometrist | 73 S Main Street, Medford, NJ 08055 | 2007-02-05 |
| 1164589230 | Steven Paul Mullins | Optometrist | 1740 Delta Waters Rd, Suite 100, Medford, OR 97504-9175 | 2007-01-02 |
| 1083786644 | Douglas Guy Smith | Optometrist | 585 Murphy Rd, Medford, OR 97504-8128 | 2006-11-15 |
| Find all providers in MEDFORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.