NPIMap

Organization Active NPI

Aeg Ohio Professional PC

Doing business as Shawnee Optical

  • Optometrist
  • Erie, PA
National Provider Identifier
1306445408
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
AEG OHIO PROFESSIONAL PC
Doing business as
Shawnee Optical
Practice address
128 W 12TH St Ste 201
Erie, PA 16501-1750
Phone
(814) 456-9925
NPI assigned
Oct 20, 2020
Last updated
Feb 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Authorized official

Name
Melissa Allison
Title
Sr. Director MVC
Phone
(314) 741-8183

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

128 W 12TH St Ste 201
Erie, PA 16501-1750

Mailing address

211 E Broadway
Alton, IL 62002-6220
Phone (618) 462-9818

Other names 1

  • Shawnee Optical Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Aeg Ohio Professional PC15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Locations

128 W 12th St
Ste 201
Erie, PA 16501
Phone (814) 456-9925

NPI Registry JSON

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

{
    "created_epoch": "1603152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739923200000",
    "number": "1306445408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 E BROADWAY",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026220",
            "telephone_number": "618-462-9818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 W 12TH ST STE 201",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165011750",
            "telephone_number": "814-456-9925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AEG OHIO PROFESSIONAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-20",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A",
        "authorized_official_last_name": "ALLISON",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "SR. DIRECTOR MVC",
        "authorized_official_telephone_number": "314-741-8183"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shawnee Optical",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Shawnee Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; 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.