Individual provider Active NPI

Christopher W Colvin, OD

  • Optometrist
  • Springfield, OH
National Provider Identifier
1528063963
Registry record updated Nov 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4550 Issued in OH
Practice address
1674 N Limestone St
Springfield, OH 45503-2652
Phone
(937) 399-4101
Fax
(937) 399-2346
NPI assigned
Jun 14, 2005
Last updated
Nov 30, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4550 OH Primary

Addresses

Primary practice location

1674 N Limestone St
Springfield, OH 45503-2652

Mailing address

420 Sintz Road
Springfield, OH 45504
Phone (937) 322-3871

Other identifiers 6

IdentifierTypeStateIssuer
2201143OtherOHUNITED HEALTH CARE
0995240MedicaidOH
200806361027OtherOHCARESOURCE
11308OtherOHCORDINATED VISION CARE
4669244OtherOHAETNA
000000340281OtherOHANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040609000997 OH Practitioner - Optometry 5496738619 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of Ohio, LLCGroup PAC ID 7719211010, 72 clinicians

Practice addresses (Care Compare)

1674 N Limestone St
Springfield, OH 45503-2652
Phone (937) 399-4101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Ohio, LLC Optometrist CurrentSince Feb 3, 2020 Accepting new patients
Myeyedr Optometry of Ohio, LLC Optometrist CurrentSince Feb 3, 2020 Accepting new patients
Myeyedr Optometry of Ohio, LLC Optometrist Current Accepting new patients
John P Downer, OD, Inc. Optometrist Past Accepting new patients
Myeyedr Optometry of Virginia, PLLC Optometrist Past Accepting new patients

Locations

1674 N Limestone St
Springfield, OH 45503
Phone (937) 322-6411

1674 N Limestone St
Ste 140
Springfield, OH 45503
Phone (937) 399-4101

8254 Mayberry Sq N
Sylvania, OH 43560
Phone (419) 885-5300

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322611200000",
    "number": "1528063963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 SINTZ ROAD",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "45504",
            "telephone_number": "937-322-3871",
            "fax_number": "937-399-2346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1674 N LIMESTONE ST",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455032652",
            "telephone_number": "937-399-4101",
            "fax_number": "937-399-2346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLVIN",
        "first_name": "CHRISTOPHER",
        "middle_name": "W",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-14",
        "last_updated": "2011-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "2201143",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0995240",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE",
            "identifier": "200806361027",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORDINATED VISION CARE",
            "identifier": "11308",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4669244",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000340281",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OH

Sources for this page

Verify at the official NPI Registry.