NPIMap

Organization Active NPI

Suburban Vision Care, Inc.

  • Eyewear Supplier
  • Boardman, OH
National Provider Identifier
1700078714
Registry record updated Jul 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
152W00000X Issued in OH
Legal business name
SUBURBAN VISION CARE, INC.
Practice address
6828 Market St
Boardman, OH 44512-4503
Phone
(330) 629-9870
Fax
(330) 629-9791
NPI assigned
Aug 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2008

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

Authorized official

Name
Dr. Christopher W. Shoemaker, ODNPI 1184674566
Title
President
Phone
(330) 629-9870

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 3497 / T1403 OH
Eyewear Supplier 332H00000X 152W00000X OH Primary

Addresses

Primary practice location

6828 Market St
Boardman, OH 44512-4503

Mailing address

6828 Market St
Boardman, OH 44512-4503
Phone (330) 629-9870

Other identifiers 3

IdentifierTypeStateIssuer
302544644012OtherOHMEDICAL MUTUAL
2280106MedicaidOH
000000139002OtherOHANTHEM

Other names 1

  • Suburban Vision Care Doing business as

National Provider Directory

National Provider Directory

Locations

6828 Market St
Boardman, OH 44512
Phone (330) 629-9870

Practitioners & affiliated clinicians

Practitioners 3

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": "1187049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215734400000",
    "number": "1700078714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6828 MARKET ST",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445124503",
            "telephone_number": "330-629-9870",
            "fax_number": "330-629-9791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6828 MARKET ST",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445124503",
            "telephone_number": "330-629-9870",
            "fax_number": "330-629-9791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUBURBAN VISION CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-14",
        "last_updated": "2008-07-11",
        "status": "A",
        "authorized_official_last_name": "SHOEMAKER",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-629-9870",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3497 / T1403",
            "primary": false
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "OH",
            "license": "152W00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL MUTUAL",
            "identifier": "302544644012",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2280106",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000139002",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Suburban Vision Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boardman, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2008; 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.