Organization Active NPI

Enochs Eye Care PLLC

  • Optometrist
  • Suffolk, VA
National Provider Identifier
1053458000
Registry record updated Nov 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618001031 Issued in VA
Legal business name
ENOCHS EYE CARE PLLC
Practice address
3575 Bridge Rd
Suite 21
Suffolk, VA 23435-1805
Phone
(757) 638-2015
Fax
(757) 638-2010
NPI assigned
Jan 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2007

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

Authorized official

Name
Dr. Stephen Mark Enochs, O.D.NPI 1902875792
Title
Owner Optometrist
Phone
(757) 638-2015

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 0618001031 VA Primary

Addresses

Primary practice location

3575 Bridge Rd
Suite 21
Suffolk, VA 23435-1805

Mailing address

3575 Bridge Rd
Suite 21
Suffolk, VA 23435-1805
Phone (757) 638-2015

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070208000117 VA Part B Supplier - Clinic/Group Practice 0941202782 Receives reassigned benefits from 3 practitioners
Practice locations: Suffolk, VA

National Provider Directory

National Provider Directory

Locations

3575 Bridge Rd
Ste 19
Suffolk, VA 23435
Phone (757) 638-2015

3575 Bridge Rd
Ste 21
Suffolk, VA 23435
Phone (757) 638-2015

Interoperability endpoints

  • Direct secure messaging: markenochs@enochseyecare.eyefinity-direct.com
  • Direct secure messaging: kimmistiszyn@enochseyecare.eyefinity-direct.com
  • Direct secure messaging: tjshaffer@enochseyecare.eyefinity-direct.com

Practitioners & affiliated clinicians

Practitioners 3

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": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196035200000",
    "number": "1053458000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3575 BRIDGE RD",
            "address_2": "SUITE 21",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234351805",
            "telephone_number": "757-638-2015",
            "fax_number": "757-638-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3575 BRIDGE RD",
            "address_2": "SUITE 21",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234351805",
            "telephone_number": "757-638-2015",
            "fax_number": "757-638-2010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENOCHS EYE CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2007-11-26",
        "status": "A",
        "authorized_official_last_name": "ENOCHS",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "OWNER OPTOMETRIST",
        "authorized_official_telephone_number": "757-638-2015",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2007; 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.