NPIMap

Organization Active NPI

Shirley R. Daniel, O.D. & Terry E. Daniel, O.D., Inc.

  • Optometrist
  • Berea, OH
National Provider Identifier
1407938244
Registry record updated Aug 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2940 Issued in OH
Legal business name
SHIRLEY R. DANIEL, O.D. & TERRY E. DANIEL, O.D., INC.
Practice address
295 High St
Berea, OH 44017-1833
Phone
(440) 234-3800
Fax
(440) 234-2318
NPI assigned
Oct 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2013

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

Authorized official

Name
Dr. Terry Edward Daniel, ODNPI 1609815844
Title
Optometrist - President
Phone
(440) 234-3800

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 2940 OH Primary

Addresses

Primary practice location

295 High St
Berea, OH 44017-1833

Mailing address

295 High St
Berea, OH 44017-1833
Phone (440) 234-3800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090312000014 OH Part B Supplier - Clinic/Group Practice 7719987452 Receives reassigned benefits from 4 practitioners
Practice locations: Berea, OH

National Provider Directory

National Provider Directory

Locations

359 Front St
Ste 4
Berea, OH 44017
Phone (440) 234-3800

295 High St
Berea, OH 44017
Phone (440) 234-3800

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": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376438400000",
    "number": "1407938244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 HIGH ST",
            "city": "BEREA",
            "state": "OH",
            "postal_code": "440171833",
            "telephone_number": "440-234-3800",
            "fax_number": "440-234-2318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 HIGH ST",
            "city": "BEREA",
            "state": "OH",
            "postal_code": "440171833",
            "telephone_number": "440-234-3800",
            "fax_number": "440-234-2318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHIRLEY R. DANIEL, O.D. & TERRY E. DANIEL, O.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2013-08-14",
        "status": "A",
        "authorized_official_last_name": "DANIEL",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "OPTOMETRIST - PRESIDENT",
        "authorized_official_telephone_number": "440-234-3800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OH",
            "license": "2940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berea, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2013; 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.