Shiloh Optometric Center Inc

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

SHILOH OPTOMETRIC CENTER INC

Practice address

5419 N Main St
Dayton, OH 45415-3454

Phone

(937) 278-0675

Fax

(937) 278-9535

NPI assigned

Nov 30, 2006

Organization subpart

No

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

Authorized official

Name

Dr. David Morris Stine, O.D.

Title

Owner

Phone

(937) 278-0675

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1104993229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5419 N MAIN ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454153454",
            "telephone_number": "937-278-0675",
            "fax_number": "937-278-9535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5419 N MAIN ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454153454",
            "telephone_number": "937-278-0675",
            "fax_number": "937-278-9535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHILOH OPTOMETRIC CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "STINE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "MORRIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-278-0675",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM GROUP NUMBER",
            "identifier": "SH9329161",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA GROUP NUMBER",
            "identifier": "0645426",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2353859",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jenna Leigh Shevlin, D.D.S
• David William Shie, M.D.
• John Mark Shie, M.D.
• Staci Elaine Shields, CNS
• Shiloh Family Medicine LLC
• Megan Elizabeth Shilt
• Joon Shim, M.D.
• Charles T Shine, CRNA
• Najee Shine
• Nekema Shine

• Optometrist in Dayton, OH
• Providers in Dayton, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.