NPIMap

Organization Active NPI

Portage Vision Care LLC

  • Optometrist
  • Ravenna, OH
National Provider Identifier
1376735118
Registry record updated Dec 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4291T63 Issued in OH
Legal business name
PORTAGE VISION CARE LLC
Practice address
950 E Main St
Ravenna, OH 44266-3326
Phone
(330) 296-0100
Fax
(330) 296-0105
NPI assigned
Aug 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2007

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

Authorized official

Name
Dr. Daniel L Jones, ODNPI 1407812530
Title
Owner
Phone
(330) 296-0100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 4291T63 OH Primary

Addresses

Primary practice location

950 E Main St
Ravenna, OH 44266-3326

Mailing address

950 E Main St
PO Box 1021
Ravenna, OH 44266-3326
Phone (330) 296-0100

National Provider Directory

National Provider Directory

Locations

6942 State Route 44
Ravenna, OH 44266
Phone (216) 297-5723

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1187136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196812800000",
    "number": "1376735118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 E MAIN ST",
            "address_2": "PO BOX 1021",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442663326",
            "telephone_number": "330-296-0100",
            "fax_number": "330-296-0105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 E MAIN ST",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442663326",
            "telephone_number": "330-296-0100",
            "fax_number": "330-296-0105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTAGE VISION CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-15",
        "last_updated": "2007-12-05",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "330-296-0100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4291T63",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ravenna, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2007; 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.