Organization Active NPI

Club View Vision Center, Inc.

  • Optometrist
  • Bucyrus, OH
National Provider Identifier
1841376753
Registry record updated May 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4086 Issued in OH
Legal business name
CLUB VIEW VISION CENTER, INC.
Practice address
1650 E Mansfield St
Bucyrus, OH 44820-2014
Phone
(419) 562-0744
Fax
(419) 562-3861
NPI assigned
Oct 31, 2006
Last updated
May 28, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2008

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

Authorized official

Name
Thomas M Britton, ODNPI 1730292046
Title
President
Phone
(419) 562-0744

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4086 OH Primary

Addresses

Primary practice location

1650 E Mansfield St
Bucyrus, OH 44820-2014

Mailing address

1650 E Mansfield St
PO Box 744
Bucyrus, OH 44820-2014
Phone (419) 562-0744

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20061102000477 OH Part B Supplier - Clinic/Group Practice 3274530365 Receives reassigned benefits from 1 practitioner
Practice locations: Bucyrus, OH
O20100930093395 OH DME Supplier - Physician - OptometristDME Supplier - Optician 3274530365 Practice locations: Bucyrus, OH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Club View Vision Center, Inc.1650 E Mansfield St, Bucyrus, OH 44820-2014(419) 562-0744 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Feb 26, 2002

National Provider Directory

National Provider Directory

Locations

1650 E Mansfield St
Bucyrus, OH 44820
Phone (419) 562-0744

Practitioners & affiliated clinicians

Practitioners 3

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": "1162252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211932800000",
    "number": "1841376753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 E MANSFIELD ST",
            "address_2": "PO BOX 744",
            "city": "BUCYRUS",
            "state": "OH",
            "postal_code": "448202014",
            "telephone_number": "419-562-0744",
            "fax_number": "419-562-3861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 E MANSFIELD ST",
            "city": "BUCYRUS",
            "state": "OH",
            "postal_code": "448202014",
            "telephone_number": "419-562-0744",
            "fax_number": "419-562-3861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLUB VIEW VISION CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-31",
        "last_updated": "2008-05-28",
        "status": "A",
        "authorized_official_last_name": "BRITTON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "419-562-0744",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bucyrus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.