Individual provider Active NPI

Lynette Sue Powell, O.D.

  • Optometrist
  • Oregon, OH
National Provider Identifier
1730195637
Registry record updated Apr 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3487 T202 Issued in OH
Practice address
3975 Navarre Ave
Oregon, OH 43616-3437
Phone
(419) 698-4949
Fax
(419) 698-9948
NPI assigned
Jul 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3487 T202 OH Primary

Addresses

Primary practice location

3975 Navarre Ave
Oregon, OH 43616-3437

Mailing address

3975 Navarre Ave
Oregon, OH 43616-3437
Phone (419) 698-4949

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080709000431 OH Practitioner - Optometry 4082786579 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3487OHMDChiropractor
3487 T202OHMDOptometrist
03487OHMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Powell Vision Clinic, LLC Optometrist CurrentSince May 1, 2017 Accepting new patients

Locations

3975 Navarre Ave
Oregon, OH 43616
Phone (419) 698-4949

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460332800000",
    "number": "1730195637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3975 NAVARRE AVE",
            "city": "OREGON",
            "state": "OH",
            "postal_code": "436163437",
            "telephone_number": "419-698-4949",
            "fax_number": "419-698-9948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3975 NAVARRE AVE",
            "city": "OREGON",
            "state": "OH",
            "postal_code": "436163437",
            "telephone_number": "419-698-4949",
            "fax_number": "419-698-9948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "LYNETTE",
        "middle_name": "SUE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2016-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3487  T202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oregon, OH

Sources for this page

Verify at the official NPI Registry.