Perrysburg Eye Center, Inc.

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

PERRYSBURG EYE CENTER, INC.

Practice address

351 E Boundary St
Perrysburg, OH 43551-2760

Phone

(419) 874-3125

Fax

(419) 874-8606

NPI assigned

Aug 2, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Stephen E Clark, M.D.NPI 1134122948

Title

President/Medical Director

Phone

(419) 874-3125

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Perrysburg Eye Center, Inc.

  • Ophthalmology Physician
  • Perrysburg, OH
  • NPI 1366475139

  2567483092

  Same PAC ID

Tax ID family

Perrysburg Eye Center Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Perrysburg Eye Center, Inc.

  • Ophthalmology Physician
  • Perrysburg, OH
  • NPI 1366475139
  NPD tax ID

Locations

Practitioners 3

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

• Stephen E. Clark, M.D.

  • Ophthalmology Physician
  • Perrysburg, OH
  • NPI 1134122948
  NPD Authorized official
• Reed T Roth, O.D.

  • Optometrist
  • Perrysburg, OH
  • NPI 1679576474
  NPD
• Erica Leigh Smith, O.D.

  • Optometrist
  • Chillicothe, OH
  • NPI 1750956538
  NPD

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467469486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 E BOUNDARY ST",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435512760",
            "telephone_number": "419-874-3125",
            "fax_number": "419-874-8606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 E BOUNDARY ST",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435512760",
            "telephone_number": "419-874-3125",
            "fax_number": "419-874-8606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERRYSBURG EYE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "419-874-3125",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Perrysburg City Office of Corporation Clerk
• Perrysburg Commons Senior Housing-Perrysburg Oh LLC
• Perrysburg Counseling Services, LLC
• Perrysburg Exempted Village School District
• Perrysburg Eye Center, Inc.
• Perrysburg Family Physicians LLC
• Perrysburg Ft Meigs Family Practice
• Perrysburg Healthcare and Rehabilitation Center LLC
• Perrysburg Hearing Center LLC
• Perrysburg Oh Health & Rehab Opco LLC

• Eyewear Supplier in Perrysburg, OH
• Providers in Perrysburg, OH by specialty
• Eyewear Supplier in Ohio

• 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.
• 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.