NPIMap

Organization Active NPI

Laurel Eye Clinic

  • Durable Medical Equipment & Medical Supplies
  • Grove City, PA
National Provider Identifier
1700994167
Registry record updated Mar 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
LAUREL EYE CLINIC
Practice address
215 S Broad St # 217
Grove City, PA 16127-1503
Phone
(724) 458-4840
NPI assigned
Aug 27, 2006
Last updated
Mar 26, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2013

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

Authorized official

Name
Jolynn Cook
Title
Administrator
Phone
(814) 849-8344

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

215 S Broad St # 217
Grove City, PA 16127-1503

Mailing address

215 S Broad St # 217
Grove City, PA 16127-1503
Phone (724) 458-4840

Other identifiers 1

IdentifierTypeStateIssuer
CF3515OtherRAILROAD MEDICARE GROUP #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930085307 PA DME Supplier - Physician - OptometristDME Supplier - Physician - Ophthalmology 9537061692 Practice locations: Grove City, PA

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Shirley E Ruth OD9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

215 S Broad St
#217
Grove City, PA 16127
Phone (724) 458-4840

Practitioners & affiliated clinicians

Practitioners 9

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": "1156636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364256000000",
    "number": "1700994167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 S BROAD ST # 217",
            "city": "GROVE CITY",
            "state": "PA",
            "postal_code": "161271503",
            "telephone_number": "724-458-4840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 S BROAD ST # 217",
            "city": "GROVE CITY",
            "state": "PA",
            "postal_code": "161271503",
            "telephone_number": "724-458-4840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAUREL EYE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-27",
        "last_updated": "2013-03-26",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "JOLYNN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "814-849-8344"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP #",
            "identifier": "CF3515",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grove City, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2013; 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.