Active NPI
Janice Eula Coates, O.D.
- Optometrist
- Dayton, OH
National Provider Identifier
1609091982
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 3450 T1613
- Practice address
- 4387 Parkway Dr
Dayton, OH 45416-1638 - Phone
- (937) 278-7391
- Fax
- (937) 278-9418
- NPI assigned
- Apr 13, 2007
- Sex
- Female
- 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 | 3450 T1613 | OH | Primary |
Addresses
Primary practice location
4387 Parkway Dr
Dayton, OH 45416-1638
Mailing address
4387 Parkway Dr
Dayton, OH 45416-1638
Phone (937) 278-7391
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 23693 | Other | OH | SPECTERA |
| 31238 | Other | OH | DAVIS VISION |
| 360296 | Other | OH | NATIONAL VISION SERVICE |
| 903323 | Other | OH | BLOCK VISION |
| 0419612 | Medicaid | OH | |
| 2983 | Other | OH | VISION OF AMERICA |
| 142338 | Other | OH | EYE MED |
| 310981905026 | Other | OH | CARESOURCE |
| 10277 | Other | OH | COORDINATED VISION CARE |
| 142338 | Other | OH | COLE VISION |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20131217001120 | OH | Practitioner - Optometry | 7416183017 | Practice locations: Dayton, OH |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3450 T1613 | OH | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1609091982",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4387 PARKWAY DR",
"city": "DAYTON",
"state": "OH",
"postal_code": "454161638",
"telephone_number": "937-278-7391",
"fax_number": "937-278-9418"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4387 PARKWAY DR",
"city": "DAYTON",
"state": "OH",
"postal_code": "454161638",
"telephone_number": "937-278-7391",
"fax_number": "937-278-9418"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COATES",
"first_name": "JANICE",
"middle_name": "EULA",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-13",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OH",
"license": "3450 T1613",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SPECTERA",
"identifier": "23693",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DAVIS VISION",
"identifier": "31238",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATIONAL VISION SERVICE",
"identifier": "360296",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLOCK VISION",
"identifier": "903323",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0419612",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VISION OF AMERICA",
"identifier": "2983",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EYE MED",
"identifier": "142338",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARESOURCE",
"identifier": "310981905026",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COORDINATED VISION CARE",
"identifier": "10277",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COLE VISION",
"identifier": "142338",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.