Active NPI
My Eye Shoppe,LLC
- Optician
- Norwalk, CT
National Provider Identifier
1821410747
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 00408
- Legal business name
- MY EYE SHOPPE,LLC
- Practice address
- 650 Main Ave
Norwalk, CT 06851-1126 - Phone
- (203) 939-1880
- NPI assigned
- Jan 12, 2014
- Last updated
- Nov 6, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michelle Clement
- Title
- Manager
- Phone
- (203) 939-1880
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Eyewear Supplier | 332H00000X | NU | ||
| Optometrist | 152W00000X | NU | ||
| Optician | 156FX1800X | NU | ||
| Optician | 156FX1800X | 00408 | CT | Primary |
Addresses
Primary practice location
650 Main Ave
Norwalk, CT 06851-1126
Mailing address
650 Main Ave
Norwalk, CT 06851-1126
Phone (203) 939-1880
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 008061865 | Medicaid | CT |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1389484800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1446768000000",
"number": "1821410747",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "650 MAIN AVE",
"city": "NORWALK",
"state": "CT",
"postal_code": "068511126",
"telephone_number": "203-939-1880"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 MAIN AVE",
"city": "NORWALK",
"state": "CT",
"postal_code": "068511126",
"telephone_number": "203-939-1880"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MY EYE SHOPPE,LLC",
"organizational_subpart": "NO",
"enumeration_date": "2014-01-12",
"last_updated": "2015-11-06",
"status": "A",
"authorized_official_last_name": "CLEMENT",
"authorized_official_first_name": "MICHELLE",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "203-939-1880"
},
"taxonomies": [
{
"code": "332H00000X",
"taxonomy_group": "",
"desc": "Eyewear Supplier",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "CT",
"license": "00408",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "008061865",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Norwalk, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.