NPIMap

Aeg Ohio Professional PC

Organization Active NPI Optometrist · Springfield, OH

NPI 1386449692 · NPPES record last updated Feb 19, 2025

Key facts

NPI
1386449692
Entity type
Organization (NPI type 2)
Primary specialty
Optometrist 152W00000X
Legal business name
AEG OHIO PROFESSIONAL PC
Practice address
1024 N Plum St
Springfield, OH 45504-2108
Phone
(937) 342-1988
NPI assigned
Feb 19, 2025
Organization subpart
No

Authorized official

Name
Melissa Allison
Title
Sr. Director MVC
Phone
(314) 741-8183

Corporate family (same tax ID) 14

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

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2292212Aeg Ohio Professional PC Dba
1024 N Plum Street, Springfield, OH 45504		Certificate of waiverOct 22, 2027

National Provider Directory

Tax ID family
Aeg Ohio Professional PC (15 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist
Group: 193400000X SINGLE SPECIALTY GROUP		 152W00000X Yes

Addresses

Primary practice location

1024 N Plum St
Springfield, OH 45504-2108

Mailing address

111 E 4TH St Ste 440
Alton, IL 62002-6206
Phone (314) 741-8183

Other names

  • Comprehensive EyeCare - Springfield Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 19, 2025.

{
    "created_epoch": "1739923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739923200000",
    "number": "1386449692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E 4TH ST STE 440",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026206",
            "telephone_number": "314-741-8183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1024 N PLUM ST",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455042108",
            "telephone_number": "937-342-1988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AEG OHIO PROFESSIONAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-19",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A",
        "authorized_official_last_name": "ALLISON",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "SR. DIRECTOR MVC",
        "authorized_official_telephone_number": "314-741-8183"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Comprehensive EyeCare - Springfield",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Springfield, OH

All providers in Springfield, OH · Optometrist in Ohio

Sources for this page

Verify at the official NPI Registry.