NPIMap

Organization Active NPI

Joseph M. Bannon OD Inc.

  • Optometrist
  • Bellaire, OH
National Provider Identifier
1104996818
Registry record updated Aug 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3766 Issued in OH
Legal business name
JOSEPH M. BANNON OD INC.
Practice address
3372 Belmont St
Bellaire, OH 43906-1523
Phone
(740) 676-2574
NPI assigned
Nov 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2008

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

Authorized official

Name
Joseph M. Bannon
Title
President
Phone
(740) 676-2574

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 3766 OH Primary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 797D WV

Addresses

Primary practice location

3372 Belmont St
Bellaire, OH 43906-1523

Mailing address

3372 Belmont St
Bellaire, OH 43906-1523
Phone (740) 676-2574

Other identifiers 1

IdentifierTypeStateIssuer
410045918OtherOHMEDICARE RAILROAD

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217894400000",
    "number": "1104996818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3372 BELMONT ST",
            "city": "BELLAIRE",
            "state": "OH",
            "postal_code": "439061523",
            "telephone_number": "740-676-2574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3372 BELMONT ST",
            "city": "BELLAIRE",
            "state": "OH",
            "postal_code": "439061523",
            "telephone_number": "740-676-2574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH M. BANNON OD INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2008-08-05",
        "status": "A",
        "authorized_official_last_name": "BANNON",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "740-676-2574"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3766",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "WV",
            "license": "797D",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "410045918",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellaire, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2008; 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.