Organization Active NPI

Family Eye Care of Wooster LLC

  • Optometrist
  • Wooster, OH
National Provider Identifier
1528152865
Registry record updated Mar 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
FAMILY EYE CARE OF WOOSTER LLC
Practice address
961 Dover Rd
Wooster, OH 44691-4105
Phone
(330) 262-0028
Fax
(330) 262-2808
NPI assigned
Oct 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2010

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

Authorized official

Name
Dr. Rebecca J Lauffenburger, ODNPI 1881698694
Title
Owner
Phone
(330) 262-0028

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

961 Dover Rd
Wooster, OH 44691-4105

Mailing address

961 Dover Rd
Wooster, OH 44691-4105
Phone (330) 262-0028

Other identifiers 1

IdentifierTypeStateIssuer
2572354MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050421000042 OH Part B Supplier - Clinic/Group Practice 2961440847 Receives reassigned benefits from 1 practitioner
Practice locations: Wooster, OH

National Provider Directory

National Provider Directory

Locations

961 Dover Rd
Wooster, OH 44691
Phone (330) 262-0028

Practitioners & affiliated clinicians

Practitioners 2

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": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268092800000",
    "number": "1528152865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "961 DOVER RD",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446914105",
            "telephone_number": "330-262-0028",
            "fax_number": "330-262-2808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "961 DOVER RD",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446914105",
            "telephone_number": "330-262-0028",
            "fax_number": "330-262-2808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY EYE CARE OF WOOSTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2010-03-09",
        "status": "A",
        "authorized_official_last_name": "LAUFFENBURGER",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "330-262-0028",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2572354",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wooster, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2010; 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.