Southington Optometric Care, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

SOUTHINGTON OPTOMETRIC CARE, LLC

Practice address

58 Main St
Terryville, CT 06786-5121

Phone

(860) 583-5357

Fax

(860) 621-4911

NPI assigned

Sep 20, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Heather L Theriault, OD

Title

Manager/Member

Phone

(860) 583-5357

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Southington Optometric Care, LLC

  • Optometrist
  • Southington, CT
  • NPI 1972799260

  O20091117000546

  Same enrollment

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lauren Beth Colite, O.D.

  • Optometrist
  • Hartford, CT
  • NPI 1487883484
  NPD (past)
• Garry S Kain, OD

  • Optometrist
  • Southington, CT
  • NPI 1407908775
  NPD (past)
• Kathleen Sheridan Maloney, O.D

  • Optometrist
  • Fort Myers, FL
  • NPI 1144679671
  NPD (past)

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

{
    "created_epoch": "1190246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462838400000",
    "number": "1134315427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 MAIN ST",
            "address_2": "PO BOX 52",
            "city": "TERRYVILLE",
            "state": "CT",
            "postal_code": "067865121",
            "telephone_number": "860-583-5357",
            "fax_number": "860-621-4911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 MAIN ST",
            "city": "TERRYVILLE",
            "state": "CT",
            "postal_code": "067865121",
            "telephone_number": "860-583-5357",
            "fax_number": "860-621-4911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHINGTON OPTOMETRIC CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-20",
        "last_updated": "2016-05-10",
        "status": "A",
        "authorized_official_last_name": "THERIAULT",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGER/MEMBER",
        "authorized_official_telephone_number": "860-583-5357",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004199354",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert A Salinger, LMFT
• Breeann Nichole Redman Sherman, LCSW
• Shannon Skidmore
• Smile Center Family Dentistry LLC
• Smile Haven Dental Center LLC
• Kip Leigh Sprankle, RPH
• Rebecca Swart
• Szy Inc
• David Julius Szymanski, DDS
• Terryville Family Dental, LLC

• Optometrist in Terryville, CT
• Providers in Terryville, CT by specialty
• Optometrist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.