Organization Active NPI

Fec Mobile Eye Clinic, Inc

  • Optometrist
  • Mentor, OH
National Provider Identifier
1609076462
Registry record updated Dec 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
FEC MOBILE EYE CLINIC, INC
Practice address
7200 Mentor Ave
Suite a
Mentor, OH 44060-7522
Phone
(440) 946-8758
Fax
(440) 946-0023
NPI assigned
Jul 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2014

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

Authorized official

Name
Dr. Brian J Kane, O.D.
Title
Owner
Phone
(440) 946-8758

Specialties & licenses 1

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

Addresses

Primary practice location

7200 Mentor Ave
Suite a
Mentor, OH 44060-7522

Mailing address

7200 Mentor Ave
Suite a
Mentor, OH 44060-7522
Phone (440) 946-8758

Other identifiers 1

IdentifierTypeStateIssuer
2312812MedicaidOH

National Provider Directory

National Provider Directory

Locations

7200 Mentor Ave
Ste A
Mentor, OH 44060
Phone (440) 946-0009

37131 Euclid Ave
Ste A
Willoughby, OH 44094
Phone (440) 946-8758

Practitioners & affiliated clinicians

Practitioners 1

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": "1184889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417996800000",
    "number": "1609076462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7200 MENTOR AVE",
            "address_2": "SUITE A",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440607522",
            "telephone_number": "440-946-8758",
            "fax_number": "440-946-0023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7200 MENTOR AVE",
            "address_2": "SUITE A",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440607522",
            "telephone_number": "440-946-8758",
            "fax_number": "440-946-0023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FEC MOBILE EYE CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-20",
        "last_updated": "2014-12-08",
        "status": "A",
        "authorized_official_last_name": "KANE",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "440-946-8758",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "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": "2312812",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mentor, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2014; 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.