Aeg Ohio Professional PC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

AEG OHIO PROFESSIONAL PC

Doing business as

Shawnee Optical

Practice address

2155 Allentown Rd
Lima, OH 45805-1705

Phone

(419) 228-3800

NPI assigned

Oct 20, 2020

Last updated

Feb 19, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Melissa Allison

Title

Sr. Director MVC

Phone

(314) 741-8183

Specialties & licenses 1

Addresses

Other names 1

• Shawnee Optical Doing business as

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

{
    "created_epoch": "1603152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739923200000",
    "number": "1780283952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 E BROADWAY",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026220",
            "telephone_number": "618-462-9818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 ALLENTOWN RD",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458051705",
            "telephone_number": "419-228-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AEG OHIO PROFESSIONAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-20",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A",
        "authorized_official_last_name": "ALLISON",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "SR. DIRECTOR MVC",
        "authorized_official_telephone_number": "314-741-8183"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shawnee Optical",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Shawnee Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optometrist in Lima, OH
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• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; 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.