NPIMap

Organization Active NPI

Eos Eyecare Optometric Group

  • Optometrist
  • Santa Rosa, CA
National Provider Identifier
1013320472
Registry record updated Dec 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11922TLG Issued in CA
Legal business name
EOS EYECARE OPTOMETRIC GROUP
Practice address
2655 Cleveland Ave Ste a
Santa Rosa, CA 95403-2779
Phone
(707) 542-8883
Fax
(707) 546-7787
NPI assigned
Jun 3, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2016

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

Authorized official

Name
Emily Marsh, O.D.
Title
President
Phone
(707) 542-8883

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 11922TLG CA Primary

Addresses

Primary practice location

2655 Cleveland Ave Ste a
Santa Rosa, CA 95403-2779

Mailing address

2655 Cleveland Ave Ste a
Santa Rosa, CA 95403-2779
Phone (707) 542-8883

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1401753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481155200000",
    "number": "1013320472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2655 CLEVELAND AVE STE A",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954032779",
            "telephone_number": "707-542-8883",
            "fax_number": "707-546-7787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2655 CLEVELAND AVE STE A",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954032779",
            "telephone_number": "707-542-8883",
            "fax_number": "707-546-7787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EOS EYECARE OPTOMETRIC GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-03",
        "last_updated": "2016-12-08",
        "status": "A",
        "authorized_official_last_name": "MARSH",
        "authorized_official_first_name": "EMILY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "707-542-8883",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11922TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2016; 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.