Thayer Eye Care PA

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

THAYER EYE CARE PA

Doing business as

Thayer Eye Care Center

Practice address

27 US 27 S
Lake Placid, FL 33852-7916

Phone

(863) 465-4904

Fax

(863) 465-4650

NPI assigned

Nov 14, 2006

Last updated

Sep 19, 2011By 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. Glenn R Thayer, OD

Title

President-Owner

Phone

(863) 465-4904

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• THAYER EYE CARE CENTER Doing business as

Locations

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316390400000",
    "number": "1649342767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 US 27 S",
            "city": "LAKE PLACID",
            "state": "FL",
            "postal_code": "338527916",
            "telephone_number": "863-465-4904",
            "fax_number": "863-465-4650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 US 27 S",
            "city": "LAKE PLACID",
            "state": "FL",
            "postal_code": "338527916",
            "telephone_number": "863-465-4904",
            "fax_number": "863-465-4650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THAYER EYE CARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2011-09-19",
        "status": "A",
        "authorized_official_last_name": "THAYER",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT-OWNER",
        "authorized_official_telephone_number": "863-465-4904",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FL",
            "identifier": "19418",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CM2511",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THAYER EYE CARE CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optometrist in Lake Placid, FL
• Providers in Lake Placid, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2011; 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.