Individual provider Active NPI

Cynthia Colby-Axe, O.D.

  • Optometrist
  • Chillicothe, OH
National Provider Identifier
1831290626
Registry record updated Jun 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3392 Issued in OH
Practice address
256 N Woodbridge Ave
Chillicothe, OH 45601-2245
Phone
(740) 773-4950
Fax
(740) 773-4965
NPI assigned
Sep 26, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3392 OH Primary
Corneal and Contact Management Optometrist 152WC0802X 3392 OH

Addresses

Primary practice location

256 N Woodbridge Ave
Chillicothe, OH 45601-2245

Mailing address

21 Mead Dr
Chillicothe, OH 45601-3736
Phone (740) 772-2169

Other identifiers 1

IdentifierTypeStateIssuer
0475749MedicaidOH

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
3392OHMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370476800000",
    "number": "1831290626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 MEAD DR",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456013736",
            "telephone_number": "740-772-2169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256 N WOODBRIDGE AVE",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456012245",
            "telephone_number": "740-773-4950",
            "fax_number": "740-773-4965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLBY-AXE",
        "first_name": "CYNTHIA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2013-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3392",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "OH",
            "license": "3392",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0475749",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chillicothe, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2013; 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.