Organization Active NPI

Eyecare Etc

  • Optometrist
  • Randolph, MA
National Provider Identifier
1184894057
Registry record updated Mar 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3651 Issued in MA
Legal business name
EYECARE ETC
Practice address
304 N Main St
Randolph, MA 02368-4102
Phone
(781) 963-8448
Fax
(781) 963-5289
NPI assigned
Mar 7, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2008

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

Authorized official

Name
Denise Snow Williams, O.DNPI 1710087788
Title
President
Phone
(781) 963-8448

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 3651 MA Primary

Addresses

Primary practice location

304 N Main St
Randolph, MA 02368-4102

Mailing address

304 N Main St
Randolph, MA 02368-4102
Phone (781) 963-8448

Other identifiers 1

IdentifierTypeStateIssuer
9729101MedicaidMA

National Provider Directory

National Provider Directory

Locations

304 N Main St
Randolph, MA 02368
Phone (781) 963-8448

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": "1204848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204848000000",
    "number": "1184894057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 N MAIN ST",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023684102",
            "telephone_number": "781-963-8448",
            "fax_number": "781-963-5289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 N MAIN ST",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023684102",
            "telephone_number": "781-963-8448",
            "fax_number": "781-963-5289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYECARE ETC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-07",
        "last_updated": "2008-03-07",
        "status": "A",
        "authorized_official_last_name": "SNOW WILLIAMS",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-963-8448",
        "authorized_official_credential": "O.D"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MA",
            "license": "3651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9729101",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Randolph, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2008; 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.