4247Bifocal LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

OH4839 Issued in OH

Legal business name

4247BIFOCAL LLC

Practice address

6301 Sawmill Rd
Dublin, OH 43017-1471

Phone

(614) 889-7755

Fax

(614) 889-7809

NPI assigned

Apr 30, 2010

Last updated

May 6, 2010By 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. Amy L. Havens, O.D.

Title

Optometrist

Phone

(614) 889-7755

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1272585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273104000000",
    "number": "1154648103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6301 SAWMILL RD",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430171471",
            "telephone_number": "614-889-7755",
            "fax_number": "614-889-7809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6301 SAWMILL RD",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430171471",
            "telephone_number": "614-889-7755",
            "fax_number": "614-889-7809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "4247BIFOCAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-30",
        "last_updated": "2010-05-06",
        "status": "A",
        "authorized_official_last_name": "HAVENS",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "614-889-7755",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "OH4839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Dublin, OH
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• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2010; 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.