Deep Creek Eye Care LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC001796 Issued in FL

Legal business name

DEEP CREEK EYE CARE LLC

Practice address

375 Kings Hwy
Punta Gorda, FL 33983-5222

Phone

(941) 979-6186

NPI assigned

Jun 23, 2008

Last updated

Aug 15, 2008By 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

Mrs. Patricia Buttery Radish

Title

Manager

Phone

(941) 764-6517

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

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.

• Douglas E. Radish, O.D.

  • Optometrist
  • Punta Gorda, FL
  • NPI 1053319335
  Medicare reassignment NPD

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

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218758400000",
    "number": "1801057849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 CABELLO ST",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339835206",
            "telephone_number": "941-764-6517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 KINGS HWY",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339835222",
            "telephone_number": "941-979-6186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEEP CREEK EYE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-23",
        "last_updated": "2008-08-15",
        "status": "A",
        "authorized_official_last_name": "RADISH",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "BUTTERY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "941-764-6517",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC001796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Bass Goldman
• Deborah Daniels
• Nora Ann Davis, MS ARNP PNP-BC
• Catherine E Deaett
• Marina Christine Declue
• Elmire Degraff
• David Heberto Del Castillo, MSN, FNP-C
• Estevan James Del Castillo, MD
• Amanda Del Sol Echarte
• Jennifer Delgado

• Optometrist in Punta Gorda, FL
• Providers in Punta Gorda, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2008; 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.