Coshocton Vision Center, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

5622 Issued in OH

Legal business name

COSHOCTON VISION CENTER, LLC

Doing business as

Optics Plus Vision Center

Practice address

224 Chestnut Street
Coshocton, OH 43812-1164

Phone

(740) 622-1484

Fax

(740) 622-1540

NPI assigned

Sep 19, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Charles W Fornara, O.D.NPI 1003898156

Title

Member

Phone

(740) 622-1484

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Optics Plus Vision Center Doing business as

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

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

• Coshocton Vision Center, LLC

  • Optometrist
  • Dresden, OH
  • NPI 1801104260

  O20061026000530

  Same enrollment

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charles William Fornara, O.D.

  • Optometrist
  • Coshocton, OH
  • NPI 1003898156
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1158624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571184000000",
    "number": "1376640821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 CHESTNUT STREET",
            "city": "COSHOCTON",
            "state": "OH",
            "postal_code": "438121164",
            "telephone_number": "740-622-1484",
            "fax_number": "740-622-1540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 CHESTNUT STREET",
            "city": "COSHOCTON",
            "state": "OH",
            "postal_code": "438121164",
            "telephone_number": "740-622-1484",
            "fax_number": "740-622-1540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COSHOCTON VISION CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-19",
        "last_updated": "2019-10-16",
        "status": "A",
        "authorized_official_last_name": "FORNARA",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "740-622-1484",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5622",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2873832",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optics Plus Vision Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Optics Plus Vision Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Coshocton NH LLC
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• Coshocton Opco, LLC
• Coshocton Radiology, Inc.
• Coshocton Surgical Clinic
• Coshocton Vision LLC
• County of Coshocton
• County of Coshocton
• County of Coshocton
• Rachelle Lynn Courtright, LSW

• Optometrist in Coshocton, OH
• Providers in Coshocton, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2019; 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.