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Organization Active NPI

Jack L Neely and Holly L Hanbaum PTR

  • Optometrist
  • Newark, OH
National Provider Identifier
1265816490
Registry record updated Jul 17, 2015
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Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
JACK L NEELY AND HOLLY L HANBAUM PTR
Practice address
1010 N 21St St
Newark, OH 43055-2984
Phone
(740) 366-5050
NPI assigned
Jul 17, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2015

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

Authorized official

Name
Jack Neely, O.D.
Title
Optometrist/Owner
Phone
(740) 366-5050

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

1010 N 21St St
Newark, OH 43055-2984

Mailing address

1010 N 21St St
Newark, OH 43055-2984
Phone (740) 366-5050

Other names 1

  • Neely and Hanbaum Optical Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1437091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437091200000",
    "number": "1265816490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 N 21ST ST",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430552984",
            "telephone_number": "740-366-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 N 21ST ST",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430552984",
            "telephone_number": "740-366-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACK L NEELY AND HOLLY L HANBAUM PTR",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-17",
        "last_updated": "2015-07-17",
        "status": "A",
        "authorized_official_last_name": "NEELY",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "740-366-5050",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Neely and Hanbaum Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newark, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2015; 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.