Organization Active NPI

Grant Vision Care Inc.

  • Optometrist
  • Cuyahoga Falls, OH
National Provider Identifier
1285891606
Registry record updated Apr 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3533T464 Issued in OH
Legal business name
GRANT VISION CARE INC.
Practice address
1520 Portage Trail
Cuyahoga Falls, OH 44223-2163
Phone
(330) 923-9951
Fax
(330) 923-6419
NPI assigned
May 22, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2013

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

Authorized official

Name
Dr. Drusilla Haskins Grant, ODNPI 1922165521
Title
Owner
Phone
(330) 923-9951

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 3533T464 OH Primary

Addresses

Primary practice location

1520 Portage Trail
Cuyahoga Falls, OH 44223-2163

Mailing address

1520 Portage TRL
Ste 2
Cuyahoga Falls, OH 44223-2121
Phone (330) 923-9951

Other identifiers 1

IdentifierTypeStateIssuer
3533T464OtherOHSTATE OF OHIO LICENSE NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091211000369 OH Part B Supplier - Clinic/Group Practice 6305870932 Receives reassigned benefits from 1 practitioner
Practice locations: Akron, OH; Cuyahoga Falls, OH

National Provider Directory

National Provider Directory

Locations

1520 Portage Trl
Ste 2
Cuyahoga Falls, OH 44223
Phone (330) 923-9951

1520 Portage Trl
Cuyahoga Fls, OH 44223
Phone (330) 422-9999

Practitioners & affiliated clinicians

Practitioners 1

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": "1211414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366675200000",
    "number": "1285891606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 PORTAGE TRL",
            "address_2": "STE 2",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "442232121",
            "telephone_number": "330-923-9951",
            "fax_number": "330-923-6419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 PORTAGE TRAIL",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "442232163",
            "telephone_number": "330-923-9951",
            "fax_number": "330-923-6419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANT VISION CARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-22",
        "last_updated": "2013-04-23",
        "status": "A",
        "authorized_official_last_name": "GRANT",
        "authorized_official_first_name": "DRUSILLA",
        "authorized_official_middle_name": "HASKINS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "330-923-9951",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3533T464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF OHIO LICENSE NUMBER",
            "identifier": "3533T464",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cuyahoga Falls, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 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.