Optometric Management Group LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

OPTOMETRIC MANAGEMENT GROUP LLC

Doing business as

North Star Vision Center on Bethel

Practice address

1049 Bethel Rd
Columbus, OH 43220-2609

Phone

(614) 326-1830

NPI assigned

Feb 14, 2022

Last updated

Feb 14, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Timothy D. Fries, OD, MBA, MPH

Title

Chief Visionary Officer

Phone

(614) 517-9721

Specialties & licenses 1

Addresses

Other names 1

• North Star Vision Center on Bethel Doing business as

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

{
    "created_epoch": "1644796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644796800000",
    "number": "1083369557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 N LIBERTY ST",
            "city": "POWELL",
            "state": "OH",
            "postal_code": "430658870",
            "telephone_number": "614-578-9797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1049 BETHEL RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432202609",
            "telephone_number": "614-326-1830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTOMETRIC MANAGEMENT GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-14",
        "last_updated": "2022-02-14",
        "certification_date": "2022-01-28",
        "status": "A",
        "authorized_official_last_name": "FRIES",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "CHIEF VISIONARY OFFICER",
        "authorized_official_telephone_number": "614-517-9721",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD, MBA, MPH"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Star Vision Center on Bethel",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optometrist in Columbus, OH
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• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2022; 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.