Organization Active NPI

Evans Farm Family Eye Care, LLC

  • Optometrist
  • Lewis Center, OH
National Provider Identifier
1790414845
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
EVANS FARM FAMILY EYE CARE, LLC
Practice address
5875 Evans Farm Dr.
Suite K
Lewis Center, OH 43035
Phone
(614) 524-4393
Fax
(614) 704-5393
NPI assigned
Jun 6, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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

Authorized official

Name
Megan K Krebs, ODNPI 1174918734
Title
Optometrist/Owner
Phone
(419) 773-9555

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

5875 Evans Farm Dr.
Suite K
Lewis Center, OH 43035

Mailing address

5875 Evans Farm Dr.
Suite K
Lewis Center, OH 43035
Phone (614) 524-4393

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL www.evansfarmeyecare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221007001247 OH Part B Supplier - Clinic/Group Practice 6709262132 Receives reassigned benefits from 1 practitioner
Practice locations: Lewis Center, OH

National Provider Directory

National Provider Directory

Locations

5875 Evans Farm Dr
Ste K
Lewis Center, OH 43035
Phone (614) 524-4393

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1654473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654473600000",
    "number": "1790414845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5875 EVANS FARM DR.",
            "address_2": "SUITE K",
            "city": "LEWIS CENTER",
            "state": "OH",
            "postal_code": "43035",
            "telephone_number": "614-524-4393",
            "fax_number": "614-704-5393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5875 EVANS FARM DR.",
            "address_2": "SUITE K",
            "city": "LEWIS CENTER",
            "state": "OH",
            "postal_code": "43035",
            "telephone_number": "614-524-4393",
            "fax_number": "614-704-5393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVANS FARM FAMILY EYE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-06",
        "last_updated": "2022-06-06",
        "certification_date": "2022-05-26",
        "status": "A",
        "authorized_official_last_name": "KREBS",
        "authorized_official_first_name": "MEGAN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "419-773-9555",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.evansfarmeyecare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5875 Evans Farm Dr.",
            "address_2": "Suite K",
            "city": "Lewis Center",
            "state": "OH",
            "country_code": "US",
            "postal_code": "43035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lewis Center, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.