NPIMap

Organization Active NPI

Athens Eye Care, LLC

  • Optometrist
  • Athens, OH
National Provider Identifier
1023068228
Registry record updated May 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
ATHENS EYE CARE, LLC
Practice address
14 University Estates Blvd
Suite 100
Athens, OH 45701-3375
Phone
(740) 594-2271
Fax
(740) 594-2270
NPI assigned
May 11, 2006
Last updated
May 31, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2024

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

Authorized official

Name
Dr. Shane A Foster, O.D.NPI 1538322508
Title
Owner/Physician
Phone
(740) 594-2271

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3628 OH
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

14 University Estates Blvd
Suite 100
Athens, OH 45701-3375

Mailing address

14 University Estates Blvd
Suite 100
Athens, OH 45701
Phone (740) 594-2271

Other identifiers 1

IdentifierTypeStateIssuer
0104738MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041102001204 OH Part B Supplier - Clinic/Group Practice 4981666880 Receives reassigned benefits from 10 practitioners
Practice locations: Athens, OH

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.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2143524Athens Eye Care LLC14 University Estates Blvd, Athens, OH 45701Certificate of waiverJan 30, 2028

National Provider Directory

National Provider Directory

Locations

14 University Estates Blvd
#100
Athens, OH 45701
Phone (740) 594-2271

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717113600000",
    "number": "1023068228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 UNIVERSITY ESTATES BLVD",
            "address_2": "SUITE 100",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "45701",
            "telephone_number": "740-594-2271",
            "fax_number": "740-594-2270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 UNIVERSITY ESTATES BLVD",
            "address_2": "SUITE 100",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "457013375",
            "telephone_number": "740-594-2271",
            "fax_number": "740-594-2270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHENS EYE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-24",
        "status": "A",
        "authorized_official_last_name": "FOSTER",
        "authorized_official_first_name": "SHANE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "740-594-2271",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3628",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0104738",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2024; 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.