C R Decastecker OD Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

C R DECASTECKER OD INC

Practice address

34690 Vine St
Willowick, OH 44095-5118

Phone

(440) 946-6662

Fax

(440) 946-6981

NPI assigned

May 20, 2008

Last updated

Jul 24, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Christopher R Decastecker, ODNPI 1821135526

Title

Owner

Phone

(440) 946-6662

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Christopher Robert Decastecker, O.D.

  • Optometrist
  • Willowick, OH
  • NPI 1821135526
  Authorized official Same address or phone

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

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216857600000",
    "number": "1609033323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34690 VINE ST",
            "city": "WILLOWICK",
            "state": "OH",
            "postal_code": "440955118",
            "telephone_number": "440-946-6662",
            "fax_number": "440-946-6981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34690 VINE ST",
            "city": "WILLOWICK",
            "state": "OH",
            "postal_code": "440955118",
            "telephone_number": "440-946-6662",
            "fax_number": "440-946-6981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C R DECASTECKER OD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-20",
        "last_updated": "2008-07-24",
        "status": "A",
        "authorized_official_last_name": "DECASTECKER",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "440-946-6662",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2197046",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dawn Britsky
• Neil Howard Brofman, D.M.D.
• Marquetta Sheneen Brown, STNA
• Tiffany Burns
• BV Optical (dba american eyewear)
• Adam Edward Carroll
• Gregory Carroll, RPH
• Christina Castillo, APRN
• Center for Dental Health
• Mary Ann Cervella

• Durable Medical Equipment & Medical Supplies in Willowick, OH
• Providers in Willowick, OH by specialty
• Durable Medical Equipment & Medical Supplies in Ohio

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