NPIMap

Organization Active NPI

Optilens Vision Center

  • Eyewear Supplier
  • Baltimore, MD
National Provider Identifier
1720608573
Registry record updated Apr 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
OPTILENS VISION CENTER
Practice address
1490 W Patapsco Ave Ste E
Baltimore, MD 21230-3400
Phone
(410) 355-6900
Fax
(410) 355-6910
NPI assigned
Apr 22, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2020

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

Authorized official

Name
Patrick Keith Kelly, OPTICIAN
Title
Owner
Phone
(410) 446-4386

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

1490 W Patapsco Ave Ste E
Baltimore, MD 21230-3400

Mailing address

1490 W Patapsco Ave Ste E
Baltimore, MD 21230-3400
Phone (410) 355-6900

National Provider Directory

National Provider Directory

Locations

1490 W Patapsco Ave
Ste E
Baltimore, MD 21230
Phone (410) 355-6900

NPI Registry JSON

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

{
    "created_epoch": "1587513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587513600000",
    "number": "1720608573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1490 W PATAPSCO AVE STE E",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212303400",
            "telephone_number": "410-355-6900",
            "fax_number": "410-355-6910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1490 W PATAPSCO AVE STE E",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212303400",
            "telephone_number": "410-355-6900",
            "fax_number": "410-355-6910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTILENS VISION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-22",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-446-4386",
        "authorized_official_credential": "OPTICIAN"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2020; 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.