Portsmouth Eye PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

NH0844 Issued in NH

Legal business name

PORTSMOUTH EYE PLLC

Doing business as

the eye glass shop

Practice address

38 Daniel St.
Portsmouth, NH 03801

Phone

(603) 436-4509

NPI assigned

Jun 10, 2016

Last updated

Jun 10, 2016By the provider in NPPES

Organization subpart

Yes

Parent organization

PORTSMOUTH EYE PLLCAs reported in NPPES

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

Authorized official

Name

Corissa McKallagal, O.D.

Title

Owner/Member

Phone

(603) 436-4509

Specialties & licenses 1

Addresses

Other names 1

• the eye glass shop Doing business as

Medicare fee-for-service enrollment

Enrolled in NH

Enrollment records 1

Part of

Portsmouth Eye PLLC

Practitioners 3

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.

• Corissa Anne McKallagat, O.D.

  • Optometrist
  • Newington, NH
  • NPI 1215249651
  Medicare reassignment NPD
• Sheila M White, O.D.

  • Optometrist
  • Portsmouth, NH
  • NPI 1265404610
  NPD
• Ilara K Donarum, OD

  • Optometrist
  • Portsmouth, NH
  • NPI 1770657504
  NPD (past)

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

{
    "created_epoch": "1465516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465516800000",
    "number": "1679922579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 DANIEL ST.",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "03801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 DANIEL ST.",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "03801",
            "telephone_number": "603-436-4509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTSMOUTH EYE PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PORTSMOUTH EYE PLLC",
        "enumeration_date": "2016-06-10",
        "last_updated": "2016-06-10",
        "status": "A",
        "authorized_official_last_name": "MCKALLAGAL",
        "authorized_official_first_name": "CORISSA",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "603-436-4509",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "NH",
            "license": "NH0844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "the eye glass shop",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Portsmouth Internal Medicine Associates
• Portsmouth Orthopedics, LLC (Portsmouth Orthopedics)
• Portsmouth Pediatric Dentistry

• Optometrist in Portsmouth, NH
• Providers in Portsmouth, NH by specialty
• Optometrist in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2016; 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.