NPIMap

Organization Active NPI

Quality Family Eyecare, Inc

  • Optometrist
  • Rossford, OH
National Provider Identifier
1164595203
Registry record updated May 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4846 Issued in OH
Legal business name
QUALITY FAMILY EYECARE, INC
Practice address
647 Lime City Rd
Rossford, OH 43460-1444
Phone
(419) 666-0700
Fax
(419) 666-9605
NPI assigned
Nov 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2021

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

Authorized official

Name
Dr. Angela Kathryn Jackson, ODNPI 1366435471
Title
Owner
Phone
(419) 666-0700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 4846 OH Primary

Addresses

Primary practice location

647 Lime City Rd
Rossford, OH 43460-1444

Mailing address

647 Lime City Rd
Rossford, OH 43460-1444
Phone (419) 666-0700

Other identifiers 2

IdentifierTypeStateIssuer
038272001OtherNDADMINISTAR
2051416MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070215000368 OH Part B Supplier - Clinic/Group Practice 7911909262 Receives reassigned benefits from 3 practitioners
Practice locations: Rossford, OH
O20100930073374 OH DME Supplier - Physician - Optometrist 7911909262 Practice locations: Rossford, OH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Quality Family Eyecare Inc647 Lime City Rd, Rossford, OH 43460-1444(419) 666-0700 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Oct 1, 2000

National Provider Directory

National Provider Directory

Locations

647 Lime City Rd
Rossford, OH 43460
Phone (419) 666-0700

Practitioners & affiliated clinicians

Practitioners 7

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": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621468800000",
    "number": "1164595203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "647 LIME CITY RD",
            "city": "ROSSFORD",
            "state": "OH",
            "postal_code": "434601444",
            "telephone_number": "419-666-0700",
            "fax_number": "419-666-9605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "647 LIME CITY RD",
            "city": "ROSSFORD",
            "state": "OH",
            "postal_code": "434601444",
            "telephone_number": "419-666-0700",
            "fax_number": "419-666-9605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUALITY FAMILY EYECARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "KATHRYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "419-666-0700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4846",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADMINISTAR",
            "identifier": "038272001",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2051416",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rossford, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.