Active NPI
Carol L Brown, OD
- Optometrist
- Sylvania, OH
National Provider Identifier
1750330635
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 3926T9
- Practice address
- 8254 Mayberry SQ N
Sylvania, OH 43560 - Phone
- (419) 885-5300
- Fax
- (419) 885-5308
- NPI assigned
- May 9, 2006
- Last updated
- Feb 19, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 3926T9 | OH | Primary |
| Optometrist | 152W00000X | 4901003141 | MI |
Addresses
Primary practice location
8254 Mayberry SQ N
Sylvania, OH 43560
Mailing address
8254 Mayberry SQ N
Sylvania, OH 43560
Phone (419) 885-5300
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03068 | Other | OH | PARAMOUNT |
| 0975253 | Medicaid | OH | |
| 000000136272 | Other | OH | ANTHEM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4901003141 | MI | MD | Optometrist |
| 3926 | OH | MD | Physical Therapist |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203379200000",
"number": "1750330635",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8254 MAYBERRY SQ N",
"city": "SYLVANIA",
"state": "OH",
"postal_code": "43560",
"telephone_number": "419-885-5300",
"fax_number": "419-885-5308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8254 MAYBERRY SQ N",
"city": "SYLVANIA",
"state": "OH",
"postal_code": "43560",
"telephone_number": "419-885-5300",
"fax_number": "419-885-5308"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "CAROL",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-05-09",
"last_updated": "2008-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OH",
"license": "3926T9",
"primary": true
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MI",
"license": "4901003141",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PARAMOUNT",
"identifier": "03068",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0975253",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000136272",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sylvania, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.