Individual provider Active NPI

Anna R Knight, OD

  • Optometrist
  • Canal Fulton, OH
National Provider Identifier
1609902865
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3923 Issued in OH
Practice address
2425 Locust St S
Canal Fulton, OH 44614-9391
Phone
(330) 854-1393
Fax
(330) 266-7657
NPI assigned
Feb 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3923 OH Primary

Addresses

Primary practice location

2425 Locust St S
Canal Fulton, OH 44614-9391

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

Other names 1

  • Anna Bodner Other name

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
I20090929000607 OH Practitioner - Optometry 6709922008 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 1987
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)

2425 Locust St S
Canal Fulton, OH 44614-9391
Phone (330) 854-1393

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3923OHMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Ohio, LLC Optometrist CurrentSince Mar 29, 2021 Accepting new patients
Myeyedr Optometry of Ohio, LLC Optometrist CurrentSince Mar 29, 2021 Accepting new patients
Myeyedr Optometry of Ohio, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Virginia, PLLC Optometrist Past Accepting new patients

Locations

2425 Locust St S
Canal Fulton, OH 44614
Phone (330) 854-1393

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

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1172275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1609902865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 LOCUST ST S",
            "city": "CANAL FULTON",
            "state": "OH",
            "postal_code": "446149391",
            "telephone_number": "330-854-1393",
            "fax_number": "330-266-7657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNIGHT",
        "first_name": "ANNA",
        "middle_name": "R",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-24",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNA",
            "last_name": "BODNER",
            "credential": "O.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Canal Fulton, OH

Sources for this page

Verify at the official NPI Registry.