Individual provider Active NPI

Gloria Rene' Sole

  • Optician
  • Newark, OH
National Provider Identifier
1295432722
Registry record updated Feb 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
3416SC Issued in OH
Practice address
1315 N 21St St
Newark, OH 43055-3090
Phone
(740) 364-9130
Fax
(740) 364-9159
NPI assigned
Feb 15, 2023
Last updated
Feb 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 3416SC OH Primary

Addresses

Primary practice location

1315 N 21St St
Newark, OH 43055-3090

Mailing address

1315 N 21St St
Newark, OH 43055-3090
Phone (740) 364-9130

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3416SCOHMDOptician

NPI Registry JSON

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

{
    "created_epoch": "1676419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676419200000",
    "number": "1295432722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 N 21ST ST",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430553090",
            "telephone_number": "740-364-9130",
            "fax_number": "740-364-9159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 N 21ST ST",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430553090",
            "telephone_number": "740-364-9130",
            "fax_number": "740-364-9159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLE",
        "first_name": "GLORIA",
        "middle_name": "RENE'",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-15",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "OH",
            "license": "3416SC",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Feb 15, 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.