NPIMap

Organization Active NPI

Dr. James D. Egbert, Optometrist, Inc.

  • Optometrist
  • Miamisburg, OH
National Provider Identifier
1306962980
Registry record updated Jul 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3335 Issued in OH
Legal business name
DR. JAMES D. EGBERT, OPTOMETRIST, INC.
Practice address
8118 Springboro Pike
Miamisburg, OH 45342-3786
Phone
(937) 433-9868
Fax
(937) 433-8264
NPI assigned
Mar 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2008

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

Authorized official

Name
Janet Arlene Yeazel
Title
Insurance Coordinator
Phone
(937) 236-1770

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 3335 OH Primary

Addresses

Primary practice location

8118 Springboro Pike
Miamisburg, OH 45342-3786

Mailing address

8118 Springboro Pike
Miamisburg, OH 45342-3786
Phone (937) 433-9868

Other names 1

  • Gemini Eye Care Centers Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050627000118 OH Part B Supplier - Clinic/Group Practice 5991740359 Receives reassigned benefits from 5 practitioners
2 other NPIs on this enrollment
Practice locations: Beavercreek, OH; Centerville, OH; Huber Heights, OH

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

101 E Alex Bell Rd
Centerville, OH 45459
Phone (937) 433-9868

Practitioners & affiliated clinicians

Practitioners 5

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": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215648000000",
    "number": "1306962980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8118 SPRINGBORO PIKE",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453423786",
            "telephone_number": "937-433-9868",
            "fax_number": "937-433-8264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8118 SPRINGBORO PIKE",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453423786",
            "telephone_number": "937-433-9868",
            "fax_number": "937-433-8264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. JAMES D. EGBERT, OPTOMETRIST, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2008-07-10",
        "status": "A",
        "authorized_official_last_name": "YEAZEL",
        "authorized_official_first_name": "JANET",
        "authorized_official_middle_name": "ARLENE",
        "authorized_official_title_or_position": "INSURANCE COORDINATOR",
        "authorized_official_telephone_number": "937-236-1770"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gemini Eye Care Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Miamisburg, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.