Northeast Ohio Optometric Services and Contact Lens Supply

Primary specialty

OptometristTaxonomy code 152W00000X

License

4337 T909 Issued in OH

Legal business name

NORTHEAST OHIO OPTOMETRIC SERVICES AND CONTACT LENS SUPPLY

Practice address

3547 Midway Mall
Eyemasters
Elyria, OH 44035-2458

Phone

(440) 324-9779

NPI assigned

Jul 13, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Patricia Jeanne Creatura, O.D.NPI 1417255100

Title

President

Phone

(216) 321-0811

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Patricia Jeanne Creatura, O.D.

  • Optometrist
  • Elyria, OH
  • NPI 1417255100
  NPD (past) Authorized official

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

{
    "created_epoch": "1278979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278979200000",
    "number": "1255643797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3770 NORTHWOOD RD",
            "city": "UNIVERSITY HEIGHTS",
            "state": "OH",
            "postal_code": "441183738",
            "telephone_number": "216-321-0811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3547 MIDWAY MALL",
            "address_2": "EYEMASTERS",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440352458",
            "telephone_number": "440-324-9779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST OHIO OPTOMETRIC SERVICES AND CONTACT LENS SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-13",
        "last_updated": "2010-07-13",
        "status": "A",
        "authorized_official_last_name": "CREATURA",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "JEANNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "216-321-0811",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4337 T909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0936491",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• North Ohio Heart Inc
• North Ohio Surgery, Inc.
• North Ridge Chiropractic, Inc
• Northcoast Pain Specialists LLC
• John Northcott, CDCA
• Northern Ohio Eye Consultants, Inc
• Olivia Kordrene O'Dell
• Kristine O'Neal
• Charles David O'Shaughnessy, M.D.
• Jordan Elizabeth Oberholtzer

• Optometrist in Elyria, OH
• Providers in Elyria, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2010; 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.