Organization Active NPI

Southern Tier Optometric Center Inc

  • Optometrist
  • Erie, PA
National Provider Identifier
1003896440
Registry record updated Oct 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
SOUTHERN TIER OPTOMETRIC CENTER INC
Practice address
147 W 18TH St
Erie, PA 16501-2103
Phone
(814) 454-7138
NPI assigned
Jan 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2010

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

Authorized official

Name
Mrs. Sam L Rosenswie
Title
Corporate Business Manager
Phone
(716) 372-9464

Specialties & licenses 1

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

Addresses

Primary practice location

147 W 18TH St
Erie, PA 16501-2103

Mailing address

147 W 18TH St
Erie, PA 16501-2103
Phone (814) 454-7138

Other identifiers 1

IdentifierTypeStateIssuer
1003896440OtherPANPI

Other names 1

  • Council Optometric Center Doing business as

National Provider Directory

National Provider Directory

Locations

436 Central Ave
Dunkirk, NY 14048
Phone (716) 363-6339

548 W 3rd St
Jamestown, NY 14701
Phone (716) 488-1147

168 N Union St
Olean, NY 14760
Phone (716) 372-9464

147 W 18th St
Erie, PA 16501
Phone (814) 454-7138

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287446400000",
    "number": "1003896440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 W 18TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165012103",
            "telephone_number": "814-454-7138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 W 18TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165012103",
            "telephone_number": "814-454-7138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN TIER OPTOMETRIC CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-20",
        "last_updated": "2010-10-19",
        "status": "A",
        "authorized_official_last_name": "ROSENSWIE",
        "authorized_official_first_name": "SAM",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CORPORATE BUSINESS MANAGER",
        "authorized_official_telephone_number": "716-372-9464",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1003896440",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Council Optometric Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.