Active NPI
Michael James Petrie, L.D.O.
- Optician
- Akron, OH
National Provider Identifier
1144514514
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- S.5057
- Practice address
- 3308 S Main St
Akron, OH 44319-3027 - Phone
- (330) 352-3212
- Fax
- (330) 352-3212
- NPI assigned
- Jun 2, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | S.5057 | OH | Primary |
Addresses
Primary practice location
3308 S Main St
Akron, OH 44319-3027
Mailing address
3308 S Main St
Akron, OH 44319-3027
Phone (330) 408-9055
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S.5057 | OH | MD | Optician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Petrie Eyecare | Optician | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Optician
- Akron, OH
- NPI 1457628182
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1306972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322870400000",
"number": "1144514514",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3308 S MAIN ST",
"city": "AKRON",
"state": "OH",
"postal_code": "443193027",
"telephone_number": "330-408-9055",
"fax_number": "330-968-0514"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3308 S MAIN ST",
"city": "AKRON",
"state": "OH",
"postal_code": "443193027",
"telephone_number": "330-352-3212",
"fax_number": "330-352-3212"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETRIE",
"first_name": "MICHAEL",
"middle_name": "JAMES",
"name_prefix": "Mr.",
"credential": "L.D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-06-02",
"last_updated": "2011-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "OH",
"license": "S.5057",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Akron, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.