Individual provider Active NPI

Peggy C Roesch, O.D.

  • Optometrist
  • Mason, OH
National Provider Identifier
1801971874
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3464 T1400 Issued in OH
Practice address
218 Reading Rd
Mason, OH 45040-1665
Phone
(513) 398-3886
Fax
(513) 398-9836
NPI assigned
Oct 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3464 T1400 OH Primary

Addresses

Primary practice location

218 Reading Rd
Mason, OH 45040-1665

Mailing address

218 Reading Rd
Mason, OH 45040-1665
Phone (513) 398-3886

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

LicenseStateTypeSpecialty
3464 T1400OHMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801971874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 READING RD",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450401665",
            "telephone_number": "513-398-3886",
            "fax_number": "513-398-9836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 READING RD",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450401665",
            "telephone_number": "513-398-3886",
            "fax_number": "513-398-9836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROESCH",
        "first_name": "PEGGY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3464    T1400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mason, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.