Organization Active NPI

Pro Eye Inc

  • Optometrist
  • Vernon, CT
National Provider Identifier
1710290580
Registry record updated Jul 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2807 Issued in CT
Legal business name
PRO EYE INC
Practice address
219 Talcottville Rd
Suite #3
Vernon, CT 06066-4637
Phone
(860) 872-3348
Fax
(860) 872-3643
NPI assigned
Jul 21, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2010

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

Authorized official

Name
Dr. Keith E Waton, O.D.
Title
President
Phone
(860) 872-3348

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 2807 CT Primary

Addresses

Primary practice location

219 Talcottville Rd
Suite #3
Vernon, CT 06066-4637

Mailing address

219 Talcottville Rd
Suite #3
Vernon, CT 06066-4637
Phone (860) 872-3348

Other identifiers 1

IdentifierTypeStateIssuer
00438912MedicaidCT

Other names 1

  • Pro Eye Associates Former legal business name

National Provider Directory

National Provider Directory

Locations

219 Talcottville Rd
Ste 3
Vernon Rockville, CT 06066
Phone (860) 872-3348

Practitioners & affiliated clinicians

Practitioners 1

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": "1279670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279670400000",
    "number": "1710290580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 TALCOTTVILLE RD",
            "address_2": "SUITE #3",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060664637",
            "telephone_number": "860-872-3348",
            "fax_number": "860-872-3643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 TALCOTTVILLE RD",
            "address_2": "SUITE #3",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060664637",
            "telephone_number": "860-872-3348",
            "fax_number": "860-872-3643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO EYE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-21",
        "last_updated": "2010-07-21",
        "status": "A",
        "authorized_official_last_name": "WATON",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "860-872-3348",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CT",
            "license": "2807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00438912",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pro Eye Associates",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Vernon, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2010; 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.