NPIMap

Organization Active NPI

Aeg Pennsylvania Professional, Inc

  • Optometrist
  • Harrisburg, PA
National Provider Identifier
1164259016
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
AEG PENNSYLVANIA PROFESSIONAL, INC
Practice address
2151 Linglestown Rd Ste 110
Harrisburg, PA 17110-9482
Phone
(717) 657-5030
NPI assigned
Sep 16, 2024
Last updated
Sep 16, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
AEG PENNSYLVANIA PROFESSIONAL, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Authorized official

Name
Melissa Allison
Title
Sr Director of RCM
Phone
(314) 741-8183

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

2151 Linglestown Rd Ste 110
Harrisburg, PA 17110-9482

Mailing address

111 E 4TH St Ste 440
Alton, IL 62002-6206
Phone (314) 741-8183

National Provider Directory

National Provider Directory
Tax ID family
Aeg PA Professional Inc29 organizations share this tax ID, including this one
Part of
Aeg PA Professional Inc

Other organizations with this tax ID 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1726444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726444800000",
    "number": "1164259016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E 4TH ST STE 440",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026206",
            "telephone_number": "314-741-8183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2151 LINGLESTOWN RD STE 110",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171109482",
            "telephone_number": "717-657-5030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AEG PENNSYLVANIA PROFESSIONAL, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AEG PENNSYLVANIA PROFESSIONAL, INC",
        "enumeration_date": "2024-09-16",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A",
        "authorized_official_last_name": "ALLISON",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "SR DIRECTOR OF RCM",
        "authorized_official_telephone_number": "314-741-8183"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; 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.