Individual provider Active NPI

Chelsea Locy-Fowler, O.D.

  • Optometrist
  • Ashtabula, OH
National Provider Identifier
1265881643
Registry record updated Aug 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT. 6477. Issued in OH
Practice address
3705 State Rd
Ashtabula, OH 44004-5957
Phone
(440) 997-2020
NPI assigned
Jun 7, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT. 6477. OH Primary
Optometrist 152W00000X OEG003218 PA

Addresses

Primary practice location

3705 State Rd
Ashtabula, OH 44004-5957

Mailing address

3224 Ninety Rd
Ashtabula, OH 44004-9606
Phone (440) 474-3106

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, PA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160901002385 OH Practitioner - Optometry 5698061562 Reassigns benefits to 1 organization
I20161026000926 PA Practitioner - Optometry 5698061562 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aeg Ohio Professional PCGroup PAC ID 7618207036, 80 clinicians

Practice addresses (Care Compare)

2203 W 38TH St
Erie, PA 16506-4501
Phone (814) 838-2020

33541 Aurora Rd
Solon, OH 44139-3705
Phone (440) 248-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6477OHMDPsychologist
OPT. 6477.OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Aeg Ohio Professional PC Optometrist CurrentSince Feb 19, 2020 Accepting new patients
Aeg Ohio Professional PC Optometrist CurrentSince Feb 19, 2020 Accepting new patients

Locations

3705 State Rd
Ste 103
Ashtabula, OH 44004
Phone (440) 997-2020

3705 State Rd
Ashtabula, OH 44004
Phone (440) 997-0014

33541 Aurora Rd
Solon, OH 44139
Phone (440) 248-2020

2203 W 38th St
Erie, PA 16506
Phone (814) 838-2020

2240 E 38th St
Erie, PA 16510
Phone (814) 824-3937

1200 E Campbell Rd
Ste 108
Richardson, TX 75081
Phone (972) 370-5552

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1465257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470268800000",
    "number": "1265881643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3224 NINETY RD",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440049606",
            "telephone_number": "440-474-3106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3705 STATE RD",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440045957",
            "telephone_number": "440-997-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCY-FOWLER",
        "first_name": "CHELSEA",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-07",
        "last_updated": "2016-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "OPT. 6477.",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG003218",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashtabula, OH

Sources for this page

Verify at the official NPI Registry.