Organization Active NPI

My Eye Shoppe,LLC

  • Optician
  • Norwalk, CT
National Provider Identifier
1821410747
Registry record updated Nov 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
00408 Issued in CT
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, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2015

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
008061865MedicaidCT

National Provider Directory

National Provider Directory

NPI 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.

Verify at the official NPI Registry.