NPIMap

Organization Active NPI

Providence Opticians, Inc.

  • Eyewear Supplier
  • Washington, DC
National Provider Identifier
1144468059
Registry record updated Jan 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
PROVIDENCE OPTICIANS, INC.
Practice address
1802 11TH St NW
Washington, DC 20001-5021
Phone
(202) 462-0055
Fax
(202) 462-2837
NPI assigned
Jan 30, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2009

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

Authorized official

Name
Mr. Edward M Winslow
Title
Owner/ President
Phone
(202) 462-0055

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

1802 11TH St NW
Washington, DC 20001-5021

Mailing address

1802 11TH St NW
Washington, DC 20001-5021
Phone (202) 462-0055

Other identifiers 2

IdentifierTypeStateIssuer
1538298906OtherDCBLOCK VISION
016707300MedicaidDC

National Provider Directory

National Provider Directory
Tax ID family
Providence Opticians Designer Eyewear Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1233273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233273600000",
    "number": "1144468059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 11TH ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200015021",
            "telephone_number": "202-462-0055",
            "fax_number": "202-462-2837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 11TH ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200015021",
            "telephone_number": "202-462-0055",
            "fax_number": "202-462-2837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE OPTICIANS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-30",
        "last_updated": "2009-01-30",
        "status": "A",
        "authorized_official_last_name": "WINSLOW",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/ PRESIDENT",
        "authorized_official_telephone_number": "202-462-0055",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLOCK VISION",
            "identifier": "1538298906",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016707300",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2009; 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.