CHARLES R. VANDERVORT O.D.
NPI 1629047758
Optometrist in Green River, WY

Q: What is Charles Vandervort's NPI number?

The NPI number for Charles Vandervort is 1629047758. It was assigned to this individual provider in the NPPES registry on March 14, 2006.

Q: What is Charles Vandervort's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Active since March 14, 2006

665 UINTA DR, GREEN RIVER, WY 82935(307) 875-4538(307) 875-8997 Get Directions Write a Review

NPPES record last updated: September 17, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Charles R. Vandervort O.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHARLES R. VANDERVORT O.D. (NPI 1629047758) is an individual optometrist in Green River, Wyoming, licensed in Wyoming (101T) and active in the NPI registry since March 2006.

NPPES Registry Identity

NPI1629047758

Entity TypeIndividualMale

Primary Taxonomy152W00000X

Provider Legal NameCHARLES R. VANDERVORTCredential: O.D.

Location Address665 UINTA DRGreen River, WY 82935-5031

Mailing Address665 Uinta DrGreen River, WY 82935-5031 · (307) 875-4538 · Fax (307) 875-8997

Phone(307) 875-4538

Fax(307) 875-8997

Sole ProprietorYes

Enumeration DateMarch 14, 2006

Last NPPES UpdateSeptember 17, 2012

✔ NPI 1629047758 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers

Taxonomy Code152W00000X

License✔ Licensed in WY · 101T

Definition

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.

665 UINTA DR, Green River, WY 82935

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Other Identifiers 5

Medicaid114697100WY

Medicare UPINT44133WY

Medicare ID-Type UnspecifiedW301158WY

Other001798001WY · Blue Cross Blue Shield

Other410040553WY · Railroad Medicare

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHARLES R. VANDERVORT, O.D., P.C.

Optometrist

665 UINTA DR
GREEN RIVER, WY 82935

Sweetwater County (307) 875-4538

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Charles Vandervort's NPI number?

The NPI number for Charles Vandervort is 1629047758. It was assigned to this individual provider in the NPPES registry on March 14, 2006.

Where is Charles Vandervort located?

Charles Vandervort practices at 665 Uinta Dr, Green River, WY 82935. The listed phone number is (307) 875-4538.

What is Charles Vandervort's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

When was this NPI record last updated?

The NPPES record for Charles Vandervort was last updated on September 17, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.