Organization Active NPI

Nova Vision Care, P.L.L.

  • Optometrist
  • Dayton, OH
National Provider Identifier
1295913887
Registry record updated Feb 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
NOVA VISION CARE, P.L.L.
Practice address
4248 Indian Ripple Rd
Dayton, OH 45440-3280
Phone
(937) 320-0300
Fax
(937) 320-0500
NPI assigned
Feb 5, 2008
Last updated
Feb 19, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2008

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

Authorized official

Name
Dr. Gary David Busch, O.D.NPI 1447318340
Title
Partner
Phone
(937) 320-0300

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
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

4248 Indian Ripple Rd
Dayton, OH 45440-3280

Mailing address

4248 Indian Ripple Rd
Dayton, OH 45440-3280
Phone (937) 320-0300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040624000927 OH Part B Supplier - Clinic/Group Practice 1052397809 Receives reassigned benefits from 6 practitioners
Practice locations: Beavercreek, OH

National Provider Directory

National Provider Directory

Locations

4244 Indian Ripple Rd
Ste 100
Dayton, OH 45440
Phone (937) 320-0300

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1202169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203379200000",
    "number": "1295913887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4248 INDIAN RIPPLE RD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454403280",
            "telephone_number": "937-320-0300",
            "fax_number": "937-320-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4248 INDIAN RIPPLE RD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454403280",
            "telephone_number": "937-320-0300",
            "fax_number": "937-320-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVA VISION CARE, P.L.L.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-05",
        "last_updated": "2008-02-19",
        "status": "A",
        "authorized_official_last_name": "BUSCH",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "937-320-0300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; 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.