Active NPI
Robert Gordon Shreiner, O.D.
- Optometrist
- Tiffin, OH
National Provider Identifier
1518035492
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2923 T649
- Practice address
- 190 South Washington St
Tiffin, OH 44883 - Phone
- (419) 447-6154
- Fax
- (419) 447-0434
- NPI assigned
- Dec 1, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2923 T649 | OH | Primary |
Addresses
Primary practice location
190 South Washington St
Tiffin, OH 44883
Mailing address
PO Box 808
Tiffin, OH 44883-0808
Phone (419) 447-6154
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0232797 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2923 T649 | OH | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1227052800000",
"number": "1518035492",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 808",
"city": "TIFFIN",
"state": "OH",
"postal_code": "448830808",
"telephone_number": "419-447-6154",
"fax_number": "419-447-0434"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "190 SOUTH WASHINGTON ST",
"city": "TIFFIN",
"state": "OH",
"postal_code": "44883",
"telephone_number": "419-447-6154",
"fax_number": "419-447-0434"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHREINER",
"first_name": "ROBERT",
"middle_name": "GORDON",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-01",
"last_updated": "2008-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OH",
"license": "2923 T649",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0232797",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tiffin, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.