NPIMap

Organization Active NPI

Modern Heritage Eye Care, LLC

  • Optometrist
  • Perrysburg, OH
National Provider Identifier
1265148522
Registry record updated Jan 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MODERN HERITAGE EYE CARE, LLC
Practice address
5150 Chappel Dr
Perrysburg, OH 43551-7256
Phone
(419) 873-7446
NPI assigned
Jan 30, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2023

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

Authorized official

Name
Nahrain Shasteen, ODNPI 1972732980
Title
Owner
Phone
(419) 873-7446

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 Primary

Addresses

Primary practice location

5150 Chappel Dr
Perrysburg, OH 43551-7256

Mailing address

5150 Chappel Dr
Perrysburg, OH 43551-7256
Phone (419) 873-7446

National Provider Directory

National Provider Directory

Locations

5150 Chappel Dr
Perrysburg, OH 43551
Phone (419) 873-7446

Practitioners & affiliated clinicians

Practitioners 2

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": "1675036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675036800000",
    "number": "1265148522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5150 CHAPPEL DR",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435517256",
            "telephone_number": "419-873-7446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5150 CHAPPEL DR",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435517256",
            "telephone_number": "419-873-7446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN HERITAGE EYE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-30",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A",
        "authorized_official_last_name": "SHASTEEN",
        "authorized_official_first_name": "NAHRAIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "419-873-7446",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perrysburg, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; 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.