NPIMap

Organization Active NPI

Bonavista Optics Incorporated

  • Eyewear Supplier
  • Oakwood, OH
National Provider Identifier
1477034296
Registry record updated Nov 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
OP.017041-SC Issued in OH
Legal business name
BONAVISTA OPTICS INCORPORATED
Practice address
610 Runnymede Rd
Oakwood, OH 45419-3322
Phone
(937) 250-1810
Fax
(937) 250-1812
NPI assigned
Aug 29, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2022

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

Authorized official

Name
Mrs. Bonnie J Ashley, LABOC NCLECNPI 1740661347
Title
President
Phone
(808) 634-5118

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Contact Lens FitterGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 156FC0801X
Eyewear Supplier 332H00000X OP.017041-SC OH Primary

Addresses

Primary practice location

610 Runnymede Rd
Oakwood, OH 45419-3322

Mailing address

610 Runnymede Rd
Oakwood, OH 45419-3322
Phone (937) 250-1810

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address optician1@bonavistaoptics.com Direct

National Provider Directory

National Provider Directory

Locations

2541 Far Hills Ave
Ste 101
Oakwood, OH 45419
Phone (937) 580-6324

Practitioners & affiliated clinicians

Practitioners 1

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": "1535500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667433600000",
    "number": "1477034296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 RUNNYMEDE RD",
            "city": "OAKWOOD",
            "state": "OH",
            "postal_code": "454193322",
            "telephone_number": "937-250-1810",
            "fax_number": "937-250-1812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 RUNNYMEDE RD",
            "city": "OAKWOOD",
            "state": "OH",
            "postal_code": "454193322",
            "telephone_number": "937-250-1810",
            "fax_number": "937-250-1812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BONAVISTA OPTICS INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-29",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A",
        "authorized_official_last_name": "ASHLEY",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "808-634-5118",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LABOC NCLEC"
    },
    "taxonomies": [
        {
            "code": "156FC0801X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Technician/Technologist, Contact Lens Fitter",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "OH",
            "license": "OP.017041-SC",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "optician1@bonavistaoptics.com",
            "affiliation": "N",
            "endpointDescription": "secure email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "610 Runnymede Rd",
            "city": "Oakwood",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454193322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oakwood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2022; 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.