New Boston Vision Center LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

3664 Issued in OH

Legal business name

NEW BOSTON VISION CENTER LLC

Practice address

3955 Rhodes Ave
New Boston, OH 45662

Phone

(740) 456-4143

Fax

(740) 456-6070

NPI assigned

Feb 20, 2018

Organization subpart

No

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

Authorized official

Name

Dr. David L Depugh, OD

Title

Owner

Phone

(740) 456-4143

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OH2 enrollments

Enrollment records 2

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeremy Depugh, O.D.

  • Optometrist
  • Portsmouth, OH
  • NPI 1104275999
  Medicare reassignment Care Compare group NPD
• Aaron Todd Kallner, O.D.

  • Optometrist
  • Portsmouth, OH
  • NPI 1225199607
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1519084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532044800000",
    "number": "1073013603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3955 RHODES AVE",
            "city": "NEW BOSTON",
            "state": "OH",
            "postal_code": "456624950",
            "telephone_number": "740-456-4143",
            "fax_number": "740-456-6070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3955 RHODES AVE",
            "city": "NEW BOSTON",
            "state": "OH",
            "postal_code": "45662",
            "telephone_number": "740-456-4143",
            "fax_number": "740-456-6070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW BOSTON VISION CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-20",
        "last_updated": "2018-07-20",
        "status": "A",
        "authorized_official_last_name": "DEPUGH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "740-456-4143",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DG4949",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0459454",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stella D Neal
• Neighboring Grace Christian Counseling, Inc.
• Charles Nelson
• Jodi Sue Nelson
• New Boston Local Schools
• Addisyn Renee Newman
• Laura Nichol, M.A. CCC-SLP
• Angela Rae Odle
• Ohio CVS Stores LLC
• Patricia Osborne

• Optometrist in New Boston, OH
• Providers in New Boston, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2018; 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.