NPIMap

Organization Active NPI

Maryland Vision Institute, LLC

  • Optometrist
  • Hagerstown, MD
National Provider Identifier
1811231814
Registry record updated Feb 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MARYLAND VISION INSTITUTE, LLC
Practice address
220 Champion Dr
Suite 100
Hagerstown, MD 21740-6558
Phone
(301) 791-0888
Fax
(301) 791-3611
NPI assigned
Nov 15, 2012
Last updated
Feb 10, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2015

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

Authorized official

Name
Mr. Augustus G Stern, M.D.NPI 1245405240
Title
Owner
Phone
(504) 723-0673

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X Primary
Ophthalmology Physician 207W00000X

Addresses

Primary practice location

220 Champion Dr
Suite 100
Hagerstown, MD 21740-6558

Mailing address

220 Champion Dr
Suite 100
Hagerstown, MD 21740-6558
Phone (301) 791-0888

National Provider Directory

National Provider Directory

Locations

219 S Spring St
Martinsburg, WV 25401
Phone (304) 267-9981

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423526400000",
    "number": "1811231814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 CHAMPION DR",
            "address_2": "SUITE 100",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217406558",
            "telephone_number": "301-791-0888",
            "fax_number": "301-791-3611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 CHAMPION DR",
            "address_2": "SUITE 100",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217406558",
            "telephone_number": "301-791-0888",
            "fax_number": "301-791-3611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYLAND VISION INSTITUTE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-15",
        "last_updated": "2015-02-10",
        "status": "A",
        "authorized_official_last_name": "STERN",
        "authorized_official_first_name": "AUGUSTUS",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "504-723-0673",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2015; 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.