MEDICARE: JAMES COOKE BIEBER O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	2756 T356	OH
2	152WC0802X	Corneal and Contact Management Optometrist	2756 T356	OH
3	152WS0006X	Sports Vision Optometrist	2756 T356	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	946058	OTHER	OH	AETNA INS. PROVIDER ID#
3	0286870002	OTHER	OH	DMESN
4	000000116894	OTHER	OH	ANTHEM BC/BS PROVIDER ID#
5	2200043	OTHER	OH	UNITED HEALTHCARE ID#

General Provider Information

NPI Number	:	1821090614
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES COOKE BIEBER O.D.

Provider Business Mailing Address
First Line	:	2098 TREMONT CTR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43221-3108
Country	:	US
Telephone Number	:	614-486-5205
Fax Number	:	614-486-0354

Provider Business Practice Location Address
First Line	:	2098 TREMONT CTR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43221-3108
Country	:	US
Telephone Number	:	614-486-5205
Fax Number	:	614-486-0354

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	06/17/2010

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