Ohio Retina Associates, Inc.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

OHIO RETINA ASSOCIATES, INC.

Practice address

340 Oxford St Ste 210
Dover, OH 44622-1967

Phone

(330) 602-8351

Fax

(330) 602-7500

NPI assigned

Jul 27, 2006

Last updated

Nov 1, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Lisa Vaughn

Title

Practice Administrator

Phone

(330) 966-9800

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193875200000",
    "number": "1467476069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4690 MUNSON ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447183636",
            "telephone_number": "330-966-9800",
            "fax_number": "330-966-9803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 OXFORD ST STE 210",
            "city": "DOVER",
            "state": "OH",
            "postal_code": "446221967",
            "telephone_number": "330-602-8351",
            "fax_number": "330-602-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OHIO RETINA ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-11-01",
        "status": "A",
        "authorized_official_last_name": "VAUGHN",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "330-966-9800",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0149904",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DE4090",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmology Physician in Dover, OH
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.