Bruce P Mathie

Primary specialty

OptometristTaxonomy code 152W00000X

License

4803 Issued in OH

Legal business name

BRUCE P MATHIE

Practice address

1403 W Main St
Louisville, OH 44641-2310

Phone

(330) 875-4320

Fax

(330) 875-4305

NPI assigned

Nov 2, 2007

Organization subpart

No

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

Authorized official

Name

Bruce P Mathie, ODNPI 1881685667

Title

Owner

Phone

(330) 875-4320

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

Practitioners 1

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

• Bruce P Mathie, OD

  • Optometrist
  • North Canton, OH
  • NPI 1881685667
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1193961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229904000000",
    "number": "1497934764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1403 W MAIN ST",
            "city": "LOUISVILLE",
            "state": "OH",
            "postal_code": "446412310",
            "telephone_number": "330-875-4320",
            "fax_number": "330-875-4305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1403 W MAIN ST",
            "city": "LOUISVILLE",
            "state": "OH",
            "postal_code": "446412310",
            "telephone_number": "330-875-4320",
            "fax_number": "330-875-4305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUCE P MATHIE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-02",
        "last_updated": "2008-12-22",
        "status": "A",
        "authorized_official_last_name": "MATHIE",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "330-875-4320",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL MUTUAL",
            "identifier": "297661819005",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2039127",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2708610",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000223574",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILRODE MEDICARE",
            "identifier": "410048659",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lily Botos
• Nicole Bounds, PHARMD
• Bowtana
• Terina Brazek
• Dona M Brown, PT
• Annie Bullock
• Shannon Butera
• Barbara Butler, RN
• Heather Rose Case, DPT, PT
• Crystal J Casto, BSW,LSW

• Optometrist in Louisville, OH
• Providers in Louisville, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2008; 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.