NPIMap

Organization Active NPI

Grace Vision, LLC

  • Clinic/Center
  • Reynoldsburg, OH
National Provider Identifier
1225461544
Registry record updated Aug 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
5016 Issued in OH
Legal business name
GRACE VISION, LLC
Practice address
2314 Taylor Park Dr
Reynoldsburg, OH 43068-8052
Phone
(614) 863-0071
Fax
(614) 856-0534
NPI assigned
Aug 11, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2013

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

Authorized official

Name
Dr. Dawn Lynette Hartman, O.D.NPI 1154404804
Title
Owner
Phone
(614) 946-8205

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
Clinic/Center 261Q00000X 5016 OH Primary

Addresses

Primary practice location

2314 Taylor Park Dr
Reynoldsburg, OH 43068-8052

Mailing address

6007 Woodbrook CT
Lewis Center, OH 43035-9240
Phone (614) 946-8205

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220822003459 OH Part B Supplier - Clinic/Group Practice 1658754783 Receives reassigned benefits from 5 practitioners
Practice locations: Reynoldsburg, OH

National Provider Directory

National Provider Directory

Locations

2314 Taylor Park Dr
Reynoldsburg, OH 43068
Phone (614) 863-0071

Practitioners & affiliated clinicians

Practitioners 6

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": "1376179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376179200000",
    "number": "1225461544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6007 WOODBROOK CT",
            "city": "LEWIS CENTER",
            "state": "OH",
            "postal_code": "430359240",
            "telephone_number": "614-946-8205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2314 TAYLOR PARK DR",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430688052",
            "telephone_number": "614-863-0071",
            "fax_number": "614-856-0534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE VISION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-11",
        "last_updated": "2013-08-11",
        "status": "A",
        "authorized_official_last_name": "HARTMAN",
        "authorized_official_first_name": "DAWN",
        "authorized_official_middle_name": "LYNETTE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "614-946-8205",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "OH",
            "license": "5016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reynoldsburg, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2013; 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.