Michael R Mohn, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OEG000048 Issued in PA

Practice address

453 E Lancaster Ave
Shillington, PA 19607-1371

Phone

(610) 775-3321

Fax

(610) 775-8542

NPI assigned

Jul 12, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394668800000",
    "number": "1023016284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "453 E LANCASTER AVE",
            "city": "SHILLINGTON",
            "state": "PA",
            "postal_code": "196071371",
            "telephone_number": "610-775-3321",
            "fax_number": "610-775-8542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "453 E LANCASTER AVE",
            "city": "SHILLINGTON",
            "state": "PA",
            "postal_code": "196071371",
            "telephone_number": "610-775-3321",
            "fax_number": "610-775-8542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHN",
        "first_name": "MICHAEL",
        "middle_name": "R",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2014-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "410006144",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Shillington, PA
• Providers in Shillington, PA by specialty
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2014; 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.