Timothy Allen Liette, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4857T Issued in OH

Practice address

1100 E Kemper Rd
Springdale, OH 45246-3321

Phone

(513) 346-7952

Fax

(513) 346-4042

NPI assigned

Sep 21, 2006

Last updated

Feb 23, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Liberty Eyecare, Inc.

  • Optometrist
  • Springdale, OH
  • NPI 1417270752
  NPD Authorized official
• Customeyes Vision Center, Inc.

  dba Liberty EyeCare

  • Optometrist
  • West Chester, OH
  • NPI 1962825802
  NPD (past)

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582416000000",
    "number": "1841399607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5542 SCHLADE CT",
            "city": "LIBERTY TWP",
            "state": "OH",
            "postal_code": "450449037",
            "telephone_number": "513-257-6188",
            "fax_number": "513-346-4042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E KEMPER RD",
            "city": "SPRINGDALE",
            "state": "OH",
            "postal_code": "452463321",
            "telephone_number": "513-346-7952",
            "fax_number": "513-346-4042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIETTE",
        "first_name": "TIMOTHY",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2020-02-23",
        "certification_date": "2020-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4857T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martin Bundi Kireru, BDS
• Scott J Knapke, DDS
• Erica Konopka, BCBA
• Alexandria Lach, SWT
• Liberty Eyecare, Inc.
• Life Care Home Health Services LLC
• Lillie K Home Healthcare
• Kyndell Lloyd
• Luxottica Retail North America Inc (Pearle Vision #C6566)
• Marathon Health, LLC (Marathon Health @ Springdale Town Center)

• Optometrist in Springdale, OH
• Providers in Springdale, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2020; 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.