NPIMap

Organization Active NPI

Eyetique Inc

Doing business as Eyetique

  • Optometrist
  • Stow, OH
National Provider Identifier
1316435712
Registry record updated Jul 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
EYETIQUE INC
Doing business as
Eyetique
Practice address
3330 Kent Rd
Stow, OH 44224
Phone
(330) 688-8244
Fax
(330) 688-9550
NPI assigned
May 1, 2018
Last updated
Jul 15, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2020

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

Authorized official

Name
Cathy L Short
Title
Credentialing Manager
Phone
(618) 462-9818

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X Primary

Addresses

Primary practice location

3330 Kent Rd
Stow, OH 44224

Mailing address

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

Other names 1

  • Eyetique Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Eyetique2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1525132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594771200000",
    "number": "1316435712",
    "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",
            "fax_number": "314-741-4947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 KENT RD",
            "city": "STOW",
            "state": "OH",
            "postal_code": "44224",
            "telephone_number": "330-688-8244",
            "fax_number": "330-688-9550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYETIQUE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-01",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A",
        "authorized_official_last_name": "SHORT",
        "authorized_official_first_name": "CATHY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "618-462-9818"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eyetique",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stow, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2020; 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.