Buckeye Optometry

Primary specialty

OptometristTaxonomy code 152W00000X

License

5096 Issued in OH

Legal business name

BUCKEYE OPTOMETRY

Practice address

150 McMahan Blvd
Buckeye Optical
Marion, OH 43302-5654

Phone

(740) 389-1300

Fax

(740) 389-1335

NPI assigned

Aug 10, 2011

Last updated

Jul 16, 2014By 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. Kelly Lyn Bruch, O.D.NPI 1164426078

Title

President

Phone

(740) 389-1300

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kelly Lyn Bruch, O.D.

  • Optometrist
  • Marion, OH
  • NPI 1164426078
  Authorized official Same address or phone

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

{
    "created_epoch": "1312934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405468800000",
    "number": "1124307004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 MCMAHAN BLVD",
            "address_2": "BUCKEYE OPTICAL",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433025654",
            "telephone_number": "740-389-1300",
            "fax_number": "740-389-1335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 MCMAHAN BLVD",
            "address_2": "BUCKEYE OPTICAL",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433025654",
            "telephone_number": "740-389-1300",
            "fax_number": "740-389-1335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUCKEYE OPTOMETRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-10",
        "last_updated": "2014-07-16",
        "status": "A",
        "authorized_official_last_name": "BRUCH",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "LYN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "740-389-1300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Elaine Brown, R.PH.
• Timothy Jay Brown, D.P.M.
• Bruch Eyecare & Associates, Inc.
• Kelly Lyn Bruch, O.D.
• Taylor Buck, CNP
• Priscilla Buckingham
• Bucyrus Community Hospital (Avita Marion)
• Syed Azim Bukhari, MD
• Stan Bulanov, CNP
• Tammy Lynn Burch

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.