Moshannon Valley Eye Care LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

OEG-002084 Issued in PA

Legal business name

MOSHANNON VALLEY EYE CARE LLC

Practice address

612 Clara St
Suite 1
Houtzdale, PA 16651-1115

Phone

(814) 378-7700

Fax

(814) 378-7704

NPI assigned

Jan 21, 2012

Last updated

Aug 17, 2012By 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. John Joseph Shedlock, ODNPI 1184889388

Title

Owner

Phone

(814) 378-7700

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John Joseph Shedlock, O.D.

  • Optometrist
  • Houtzdale, PA
  • NPI 1184889388
  Medicare reassignment Care Compare group NPD Authorized official
• Brooke Marie Catanese-Shedlock, O.D.

  • Optometrist
  • Du Bois, PA
  • NPI 1316193139
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1327104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345161600000",
    "number": "1205107356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 CLARA ST",
            "address_2": "SUITE 1",
            "city": "HOUTZDALE",
            "state": "PA",
            "postal_code": "166511115",
            "telephone_number": "814-378-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 CLARA ST",
            "address_2": "SUITE 1",
            "city": "HOUTZDALE",
            "state": "PA",
            "postal_code": "166511115",
            "telephone_number": "814-378-7700",
            "fax_number": "814-378-7704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSHANNON VALLEY EYE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-21",
        "last_updated": "2012-08-17",
        "status": "A",
        "authorized_official_last_name": "SHEDLOCK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "814-378-7700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG-002053",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG-002084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Sylvia Link, RDH
• Lisa Woods, LCSW
• Tracy Thomas Manno, IHP, CFNC
• Amanda Joy McCartney, M.S. CCC-SLP-L
• Kathrine Elise Millinder, RDH
• Moshannon Valley Family Dentistry
• Moshannon Valley School District
• Jennifer Marie Neely-Aurandt, M.S. OTR/L
• Pierre Boumerhi DMD LLC
• Tess Randolph

• Optometrist in Houtzdale, PA
• Providers in Houtzdale, PA by specialty
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.