Provider Demographics
NPI:1821090614
Name:BIEBER, JAMES COOKE (OD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:COOKE
Last Name:BIEBER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2098 TREMONT CTR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-3108
Mailing Address - Country:US
Mailing Address - Phone:614-486-5205
Mailing Address - Fax:614-486-0354
Practice Address - Street 1:2098 TREMONT CTR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-3108
Practice Address - Country:US
Practice Address - Phone:614-486-5205
Practice Address - Fax:614-486-0354
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-11
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2756 T356152W00000X, 152WC0802X, 152WS0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WS0006XEye and Vision Services ProvidersOptometristSports Vision
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0699070Medicaid
OH946058OtherAETNA INS. PROVIDER ID#
OH0286870002OtherDMESN
OH000000116894OtherANTHEM BC/BS PROVIDER ID#
OH2200043OtherUNITED HEALTHCARE ID#
OHT46106Medicare UPIN
OH0699070Medicaid
OHBI0157743Medicare PIN
OHBI0157744Medicare PIN