NPIMap

Organization Active NPI

Clarkson Optometry Midwest Inc

  • Optometrist
  • West Chester, OH
National Provider Identifier
1003348327
Registry record updated Jul 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4887 T1752 Issued in OH
Legal business name
CLARKSON OPTOMETRY MIDWEST INC
Practice address
8629 N Pavillion
West Chester, OH 45069-4885
Phone
(636) 200-4393
Fax
(513) 942-5321
NPI assigned
Mar 28, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
James Wachter
Title
Cmo
Phone
(636) 200-4393

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 4887 T1752 OH Primary

Addresses

Primary practice location

8629 N Pavillion
West Chester, OH 45069-4885

Mailing address

PO Box 207170
Dallas, TX 75320-7156
Phone (636) 200-4393

Other names 1

  • Cincinnati EyeCare Team Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20150113001118 OH Part B Supplier - Clinic/Group Practice 0749504165 Receives reassigned benefits from 114 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Gahanna, OH; Harrison, OH; Hilliard, OH; Kettering, OH; Lebanon, OH; Loveland, OH; Mansfield, OH; Marysville, OH…
O20250724004146 OH DME Supplier - Physician - Optometrist 0749504165 Practice locations: West Chester, OH

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Clarkson Optometry Midwest Inc8629 N Pavillion, West Chester, OH 45069-4885(513) 860-0400 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Jan 20, 2015

National Provider Directory

National Provider Directory
Tax ID family
Clarkson Optometry Midwest23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

Organizations that report the same tax identification number in the National Provider Directory.

View all 22

Practitioners & affiliated clinicians

Practitioners 83

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 83

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1490659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562544000000",
    "number": "1003348327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 207170",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753207156",
            "telephone_number": "636-200-4393",
            "fax_number": "636-527-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8629 N PAVILLION",
            "city": "WEST CHESTER",
            "state": "OH",
            "postal_code": "450694885",
            "telephone_number": "636-200-4393",
            "fax_number": "513-942-5321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARKSON OPTOMETRY MIDWEST INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-28",
        "last_updated": "2019-07-08",
        "status": "A",
        "authorized_official_last_name": "WACHTER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "636-200-4393"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4887 T1752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cincinnati EyeCare Team",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cincinnati EyeCare Team",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Chester, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.