State Street Optical, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

2251-3787 Issued in IL

Legal business name

STATE STREET OPTICAL, INC.

Practice address

1118 Broadway St
Quincy, IL 62301-2810

Phone

(217) 222-0281

Fax

(217) 222-0281

NPI assigned

Jul 27, 2006

Organization subpart

No

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

Authorized official

Name

Mr. James W Paynter

Title

President

Phone

(217) 222-0281

Specialties & licenses 1

Addresses

Other names 1

• LAMMERS OPTICAL Doing business as

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222214400000",
    "number": "1497779045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1118 BROADWAY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012810",
            "telephone_number": "217-222-0281",
            "fax_number": "217-222-0281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1118 BROADWAY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012810",
            "telephone_number": "217-222-0281",
            "fax_number": "217-222-0281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE STREET OPTICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2008-09-24",
        "status": "A",
        "authorized_official_last_name": "PAYNTER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "217-222-0281",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": "2251-3787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LAMMERS OPTICAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tonya Stamper, CNP
• Nichole Suzanne Stanley
• Tara Stark
• Laura Starman
• Nicholas Anthony Starman, D.C.
• Joshua James Statler
• Jennifer Steel
• Katherine Stegner, DT-H
• Melissa E Stembridge, FNP
• Darion Stephens, MA, NCC, LCPC

• Durable Medical Equipment & Medical Supplies in Quincy, IL
• Providers in Quincy, IL by specialty
• Durable Medical Equipment & Medical Supplies in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2008; 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.