Jeffrey W. Collins, O.D., Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4119 Issued in OH

Legal business name

JEFFREY W. COLLINS, O.D., INC.

Practice address

1845 State Route 127 N
Ste a
Eaton, OH 45320-9284

Phone

(937) 472-5665

Fax

(937) 472-3933

NPI assigned

Nov 2, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Suzanne L Leach, O.D.

Title

Doctor

Phone

(937) 472-5665

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Suzanne L. Leach O.D. Family Vision Care Other name

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

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

• Jeffrey W Collins OD Inc

  • Optometrist
  • Oxford, OH
  • NPI 1770644593

  O20050920001300

  Same enrollment

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeffrey Wade Collins, OD

  • Optometrist
  • Oxford, OH
  • NPI 1295731156
  Medicare reassignment Care Compare group NPD
• Suzanne Leah Leach, OD, O.D.

  • Optometrist
  • Eaton, OH
  • NPI 1386614782
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509667200000",
    "number": "1710065040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1845 STATE ROUTE 127 N",
            "address_2": "STE A",
            "city": "EATON",
            "state": "OH",
            "postal_code": "453209284",
            "telephone_number": "937-472-5665",
            "fax_number": "937-472-3933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1845 STATE ROUTE 127 N",
            "address_2": "STE A",
            "city": "EATON",
            "state": "OH",
            "postal_code": "453209284",
            "telephone_number": "937-472-5665",
            "fax_number": "937-472-3933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY W. COLLINS, O.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2017-11-03",
        "status": "A",
        "authorized_official_last_name": "LEACH",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "937-472-5665",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4119",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "OH",
            "license": "T938",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "OH",
            "license": "1156",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0230824",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Suzanne L. Leach O.D. Family Vision Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Optometrist in Eaton, OH
• Providers in Eaton, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2017; 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.