NPIMap

Organization Active NPI

Northwest Optometry LLC

  • Optometrist
  • Englewood, OH
National Provider Identifier
1316004187
Registry record updated Oct 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3970 Issued in OH
Legal business name
NORTHWEST OPTOMETRY LLC
Practice address
639 W National Rd
Englewood, OH 45322-1155
Phone
(937) 836-3041
Fax
(937) 836-1937
NPI assigned
Jan 2, 2007
Last updated
Oct 14, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2015

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

Authorized official

Name
Dr. Joseph Studebaker, O.D.NPI 1124022090
Title
Partner
Phone
(937) 836-3041

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 3970 OH Primary
Eyewear Supplier 332H00000X 3970 OH

Addresses

Primary practice location

639 W National Rd
Englewood, OH 45322-1155

Mailing address

639 W National Rd
Englewood, OH 45322-1155
Phone (937) 836-3041

National Provider Directory

National Provider Directory

Locations

639 W National Rd
Englewood, OH 45322
Phone (937) 836-3041

Practitioners & affiliated clinicians

Practitioners 3

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": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444780800000",
    "number": "1316004187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "639 W NATIONAL RD",
            "city": "ENGLEWOOD",
            "state": "OH",
            "postal_code": "453221155",
            "telephone_number": "937-836-3041",
            "fax_number": "937-836-1937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "639 W NATIONAL RD",
            "city": "ENGLEWOOD",
            "state": "OH",
            "postal_code": "453221155",
            "telephone_number": "937-836-3041",
            "fax_number": "937-836-1937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST OPTOMETRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2015-10-14",
        "status": "A",
        "authorized_official_last_name": "STUDEBAKER",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "937-836-3041",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3970",
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "OH",
            "license": "3970",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2015; 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.