Organization Active NPI

The Eye Center of Greenbrier Valley

  • Eyewear Supplier
  • Ronceverte, WV
National Provider Identifier
1831161322
Registry record updated Jul 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
F25588 Issued in WV
Legal business name
THE EYE CENTER OF GREENBRIER VALLEY
Practice address
101 Davis Stuart Rd
Ronceverte, WV 24970-9549
Phone
(304) 793-3937
Fax
(304) 793-2203
NPI assigned
Feb 7, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Dr. Philip N Light, MD
Title
Ceo
Phone
(304) 793-3937

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

National Provider Directory

Locations

3942 Davis Stuart Rd
Ronceverte, WV 24970
Phone (304) 647-3987

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X F25588 WV Primary

Addresses

NPPES NPI Registry

Primary practice location

101 Davis Stuart Rd
Ronceverte, WV 24970-9549

Mailing address

101 Davis Stuart Rd
Ronceverte, WV 24970-9549
Phone (304) 793-3937

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
0095836003MedicaidWV

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 30, 2008.

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217376000000",
    "number": "1831161322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 DAVIS STUART RD",
            "city": "RONCEVERTE",
            "state": "WV",
            "postal_code": "249709549",
            "telephone_number": "304-793-3937",
            "fax_number": "304-793-2203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 DAVIS STUART RD",
            "city": "RONCEVERTE",
            "state": "WV",
            "postal_code": "249709549",
            "telephone_number": "304-793-3937",
            "fax_number": "304-793-2203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE EYE CENTER OF GREENBRIER VALLEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-07",
        "last_updated": "2008-07-30",
        "status": "A",
        "authorized_official_last_name": "LIGHT",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "304-793-3937",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "WV",
            "license": "F25588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0095836003",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ronceverte, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2008; 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.