Organization Active NPI

Professional Eye Care of Tuscarawas County LLC

  • Optometrist
  • New Philadelphia, OH
National Provider Identifier
1023557998
Registry record updated Feb 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6039 Issued in OH
Legal business name
PROFESSIONAL EYE CARE OF TUSCARAWAS COUNTY LLC
Practice address
217 N Broadway St
New Philadelphia, OH 44663-2611
Phone
(330) 343-8863
Fax
(330) 343-3590
NPI assigned
Feb 13, 2017
Last updated
Feb 13, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2017

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

Authorized official

Name
Dr. Rebecca L Gambs, O.D.NPI 1245527423
Title
Owner
Phone
(330) 343-8863

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6039 OH Primary

Addresses

Primary practice location

217 N Broadway St
New Philadelphia, OH 44663-2611

Mailing address

217 N Broadway St
New Philadelphia, OH 44663-2611
Phone (330) 343-8863

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170306001865 OH Part B Supplier - Clinic/Group Practice 6709160005 Receives reassigned benefits from 1 practitioner
Practice locations: New Philadelphia, OH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1486944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486944000000",
    "number": "1023557998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 N BROADWAY ST",
            "city": "NEW PHILADELPHIA",
            "state": "OH",
            "postal_code": "446632611",
            "telephone_number": "330-343-8863",
            "fax_number": "330-343-3590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 N BROADWAY ST",
            "city": "NEW PHILADELPHIA",
            "state": "OH",
            "postal_code": "446632611",
            "telephone_number": "330-343-8863",
            "fax_number": "330-343-3590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL EYE CARE OF TUSCARAWAS COUNTY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-13",
        "last_updated": "2017-02-13",
        "status": "A",
        "authorized_official_last_name": "GAMBS",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "330-343-8863",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "6039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Philadelphia, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.