NPIMap

Organization Active NPI

Fredericksburg Eyecare LLC

  • Optometrist
  • Fredericksburg, VA
National Provider Identifier
1639521164
Registry record updated Jul 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618002489 Issued in VA
Legal business name
FREDERICKSBURG EYECARE LLC
Doing business as
Fredericksburg Eyecare
Practice address
395A Towne Centre Blvd
Fredericksburg, VA 22407
Phone
(540) 786-2020
NPI assigned
Jul 8, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2016

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

Authorized official

Name
Dr. Andrew K Chan, O.D.
Title
Optometrist
Phone
(812) 219-6286

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 0618002489 VA Primary

Addresses

Primary practice location

395A Towne Centre Blvd
Fredericksburg, VA 22407

Mailing address

395A Towne Centre Blvd
Fredericksburg, VA 22407
Phone (540) 786-2020

Other names 1

  • Fredericksburg Eyecare Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1467936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467936000000",
    "number": "1639521164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395A TOWNE CENTRE BLVD",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "22407",
            "telephone_number": "540-786-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395A TOWNE CENTRE BLVD",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "22407",
            "telephone_number": "540-786-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREDERICKSBURG EYECARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-08",
        "last_updated": "2016-07-08",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "812-219-6286",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618002489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fredericksburg Eyecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fredericksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2016; 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.