NPIMap

Organization Active NPI

Ross W Collins OD LLC

Doing business as Collins Vision Care

  • Optometrist
  • Vandalia, OH
National Provider Identifier
1649763988
Registry record updated Jun 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5709 Issued in OH
Legal business name
ROSS W COLLINS OD LLC
Doing business as
Collins Vision Care
Practice address
407 Corporate Center Dr Ste C
Vandalia, OH 45377-1177
Phone
(937) 898-9333
Fax
(937) 898-0643
NPI assigned
Jun 12, 2018
Last updated
Jun 12, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2018

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

Authorized official

Name
Dr. Ross W Collins, ODNPI 1760673271
Title
President
Phone
(937) 898-9333

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5709 OH Primary

Addresses

Primary practice location

407 Corporate Center Dr Ste C
Vandalia, OH 45377-1177

Mailing address

407 Corporate Center Dr Ste C
Vandalia, OH 45377-1177
Phone (937) 898-9333

Other names 1

  • Collins Vision Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180726000382 OH Part B Supplier - Clinic/Group Practice 7810244563 Receives reassigned benefits from 1 practitioner
Practice locations: Vandalia, OH

National Provider Directory

National Provider Directory

Locations

407 Corporate Center Dr
Ste C
Vandalia, OH 45377
Phone (937) 898-9333

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1528761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528761600000",
    "number": "1649763988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 CORPORATE CENTER DR STE C",
            "city": "VANDALIA",
            "state": "OH",
            "postal_code": "453771177",
            "telephone_number": "937-898-9333",
            "fax_number": "937-898-0643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 CORPORATE CENTER DR STE C",
            "city": "VANDALIA",
            "state": "OH",
            "postal_code": "453771177",
            "telephone_number": "937-898-9333",
            "fax_number": "937-898-0643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSS W COLLINS OD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-12",
        "last_updated": "2018-06-12",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "ROSS",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "937-898-9333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Collins Vision Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Collins Vision Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vandalia, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.