NPIMap

Organization Active NPI

Eye Site, L.L.C.

Doing business as The Eye Site

  • Optometrist
  • Millersport, OH
National Provider Identifier
1780806067
Registry record updated Dec 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5109 Issued in OH
Legal business name
EYE SITE, L.L.C.
Doing business as
The Eye Site
Practice address
12464 Lancaster St
Millersport, OH 43046-9787
Phone
(740) 467-2525
Fax
(740) 467-3015
NPI assigned
May 3, 2007
Last updated
Dec 19, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
THE EYE SITE, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 19, 2011

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

Authorized official

Name
Dr. Brett Alan Dietz, O.D.NPI 1356441802
Title
Owner
Phone
(740) 467-2525

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5109 OH Primary

Addresses

Primary practice location

12464 Lancaster St
Millersport, OH 43046-9787

Mailing address

12464 Lancaster St
PO Box 421
Millersport, OH 43046-9787
Phone (740) 467-2525

Other identifiers 2

IdentifierTypeStateIssuer
0294346MedicaidOH
2235414MedicaidOH

Other names 1

  • The Eye Site Doing business as

National Provider Directory

National Provider Directory
Part of
Eye Site LLC

Locations

12464 Lancaster St
Millersport, OH 43046
Phone (740) 467-2525

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324252800000",
    "number": "1780806067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12464 LANCASTER ST",
            "address_2": "PO BOX 421",
            "city": "MILLERSPORT",
            "state": "OH",
            "postal_code": "430469787",
            "telephone_number": "740-467-2525",
            "fax_number": "740-467-3015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12464 LANCASTER ST",
            "city": "MILLERSPORT",
            "state": "OH",
            "postal_code": "430469787",
            "telephone_number": "740-467-2525",
            "fax_number": "740-467-3015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE SITE, L.L.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE EYE SITE, LLC",
        "enumeration_date": "2007-05-03",
        "last_updated": "2011-12-19",
        "status": "A",
        "authorized_official_last_name": "DIETZ",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "740-467-2525",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0294346",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2235414",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Eye Site",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Millersport, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2011; 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.