Individual provider Active NPI

Carolyn J Maynhart, LDO

  • Optician
  • Oregon, OH
National Provider Identifier
1679270284
Registry record updated Feb 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
OP.001354SC Issued in OH
Practice address
3721 Navarre Ave
Oregon, OH 43616-3433
Phone
(419) 698-8584
Fax
(419) 698-8907
NPI assigned
Feb 14, 2023
Last updated
Feb 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X OP.001354SC OH Primary

Addresses

Primary practice location

3721 Navarre Ave
Oregon, OH 43616-3433

Mailing address

3721 Navarre Ave
Oregon, OH 43616-3433
Phone (419) 698-8584

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OP.001354SCOHMDOptician

NPI Registry JSON

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

{
    "created_epoch": "1676332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676332800000",
    "number": "1679270284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3721 NAVARRE AVE",
            "city": "OREGON",
            "state": "OH",
            "postal_code": "436163433",
            "telephone_number": "419-698-8584",
            "fax_number": "419-698-8907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3721 NAVARRE AVE",
            "city": "OREGON",
            "state": "OH",
            "postal_code": "436163433",
            "telephone_number": "419-698-8584",
            "fax_number": "419-698-8907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYNHART",
        "first_name": "CAROLYN",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "LDO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-14",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "OH",
            "license": "OP.001354SC",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oregon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2023; 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.