Ohio Retina Associates, Inc.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

OHIO RETINA ASSOCIATES, INC.

Practice address

4690 Munson St NW
Canton, OH 44718-3636

Phone

(330) 966-9800

Fax

(330) 966-9803

NPI assigned

Jul 27, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Lisa Vaughn

Title

Practice Administrator

Phone

(330) 966-9800

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193875200000",
    "number": "1093739682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4690 MUNSON ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447183636",
            "telephone_number": "330-966-9800",
            "fax_number": "330-966-9803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4690 MUNSON ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447183636",
            "telephone_number": "330-966-9800",
            "fax_number": "330-966-9803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OHIO RETINA ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-11-01",
        "status": "A",
        "authorized_official_last_name": "VAUGHN",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "330-966-9800",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DE4090",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0149888",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ohio Hospital-Based Physician Corporation
• Ohio Hospital-Based Physicians Corporation
• Ohio Physician Professional Corporation
• Ohio Prosthetics & Orthotics LTD
• Ohio Pulmonary and Sleep Physicians LLC
• Ohio Specialty Physicians Corporation
• Hailey Ohm
• Kaosisochukwu Okeke, MD
• Violet Olander, PA-C
• Emma Olee, LPCC

• All providers in Canton, OH
• Ophthalmology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2007; 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.