Eyespire Eyecare LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618002195 Issued in VA

Legal business name

EYESPIRE EYECARE LLC

Practice address

6506 Loisdale Rd Ste 102
Springfield, VA 22150-1815

Phone

(703) 719-9110

NPI assigned

Aug 27, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Ajibola Ogunnusi, OD

Title

Owner

Phone

(703) 719-9110

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1409097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425254400000",
    "number": "1326448234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6506 LOISDALE RD STE 102",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221501815",
            "telephone_number": "703-719-9110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6506 LOISDALE RD STE 102",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221501815",
            "telephone_number": "703-719-9110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYESPIRE EYECARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-27",
        "last_updated": "2015-03-02",
        "status": "A",
        "authorized_official_last_name": "OGUNNUSI",
        "authorized_official_first_name": "AJIBOLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-719-9110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618002195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Springfield, VA
• Providers in Springfield, VA by specialty
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 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.