NPIMap

Organization Active NPI

Eye Specialist Inc

  • Ophthalmology Physician
  • Wilmington, OH
National Provider Identifier
1679522809
Registry record updated Sep 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
EYE SPECIALIST INC
Practice address
721 West Main Street
Wilmington, OH 45177-2126
Phone
(937) 382-7724
Fax
(937) 382-7726
NPI assigned
May 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2014

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

Authorized official

Name
Terry Schultz, OD
Title
Center Director
Phone
(866) 587-8790

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X
Ophthalmology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

721 West Main Street
Wilmington, OH 45177-2126

Mailing address

50 N Plaza Blvd
Chillicothe, OH 45601-1757
Phone (866) 587-8790

Other identifiers 1

IdentifierTypeStateIssuer
2387199MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040107000253 OH Part B Supplier - Clinic/Group Practice 5799684957 Receives reassigned benefits from 13 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Washington Court House, OH; Worthington, OH; Wilmington, OH; Waverly, OH; Portsmouth, OH; Lancaster, OH; Grove City, OH; Circleville, OH…

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Eye Specialist Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

210 Sharon Rd
Ste B
Circleville, OH 43113
Phone (740) 477-7200

3154 Park St
Grove City, OH 43123
Phone (614) 801-8111

784 E Main St
Lancaster, OH 43130
Phone (740) 687-0100

108 N Hinde St
Washington Court House, OH 43160
Phone (740) 335-7200

505 W Emmitt Ave
Waverly, OH 45690
Phone (740) 941-3937

420 E Court St
Wshngtn Ct Hs, OH 43160
Phone (740) 335-6401

Practitioners & affiliated clinicians

Practitioners 12

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": "1146873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410739200000",
    "number": "1679522809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 N PLAZA BLVD",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456011757",
            "telephone_number": "866-587-8790",
            "fax_number": "740-774-4061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 WEST MAIN STREET",
            "city": "WILMINGTON",
            "state": "OH",
            "postal_code": "451772126",
            "telephone_number": "937-382-7724",
            "fax_number": "937-382-7726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE SPECIALIST INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-06",
        "last_updated": "2014-09-15",
        "status": "A",
        "authorized_official_last_name": "SCHULTZ",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "CENTER DIRECTOR",
        "authorized_official_telephone_number": "866-587-8790",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2387199",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2014; 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.