Organization Active NPI

Eye Care Doctors

  • Optometrist
  • Wickliffe, OH
National Provider Identifier
1053308668
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2462/T475 Issued in OH
Legal business name
EYE CARE DOCTORS
Practice address
30184 Euclid Ave
Wickliffe, OH 44092-1655
Phone
(440) 943-3663
Fax
(440) 943-3664
NPI assigned
Sep 29, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Donald Harris, O.D.
Title
President
Phone
(440) 943-3663

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 2462/T475 OH Primary

Addresses

Primary practice location

30184 Euclid Ave
Wickliffe, OH 44092-1655

Mailing address

30184 Euclid Ave
Wickliffe, OH 44092-1655
Phone (440) 943-3663

Other identifiers 1

IdentifierTypeStateIssuer
0500774MedicaidOH

National Provider Directory

National Provider Directory

Locations

30184 Euclid Ave
Wickliffe, OH 44092
Phone (440) 943-3663

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": "1127952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053308668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30184 EUCLID AVE",
            "city": "WICKLIFFE",
            "state": "OH",
            "postal_code": "440921655",
            "telephone_number": "440-943-3663",
            "fax_number": "440-943-3664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30184 EUCLID AVE",
            "city": "WICKLIFFE",
            "state": "OH",
            "postal_code": "440921655",
            "telephone_number": "440-943-3663",
            "fax_number": "440-943-3664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE CARE DOCTORS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "DONALD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "440-943-3663",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OH",
            "license": "2462/T475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0500774",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wickliffe, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.