Organization Active NPI

Philip Skovira OD Inc

  • Optometrist
  • Mayfield HTS, OH
National Provider Identifier
1346374022
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3375 T 653 Issued in OH
Legal business name
PHILIP SKOVIRA OD INC
Practice address
1285 Som Center Rd
Mayfield HTS, OH 44124-2073
Phone
(440) 995-9933
NPI assigned
Mar 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Philip Skovira, OD
Title
President
Phone
(440) 442-5745

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 3375 T 653 OH Primary

Addresses

Primary practice location

1285 Som Center Rd
Mayfield HTS, OH 44124-2073

Mailing address

6513 Gates Mills Blvd
Mayfield HTS, OH 44124-4221
Phone (440) 442-5745

Other identifiers 1

IdentifierTypeStateIssuer
0380574MedicaidOH

National Provider Directory

National Provider Directory
Tax ID family
Philip Skovira OD Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346374022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6513 GATES MILLS BLVD",
            "city": "MAYFIELD HTS",
            "state": "OH",
            "postal_code": "441244221",
            "telephone_number": "440-442-5745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1285 SOM CENTER RD",
            "city": "MAYFIELD HTS",
            "state": "OH",
            "postal_code": "441242073",
            "telephone_number": "440-995-9933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILIP SKOVIRA OD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SKOVIRA",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "440-442-5745",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3375 T 653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0380574",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayfield HTS, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.