Longmeadow Optical, LTD

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

10199942 Issued in MD

Legal business name

LONGMEADOW OPTICAL, LTD

Practice address

7420 Hayward Rd Ste 202
Frederick, MD 21702-2509

Phone

(301) 662-8866

Fax

(301) 293-6133

NPI assigned

Feb 27, 2007

Last updated

Mar 21, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dawn R. Gill, O.D.NPI 1417986233

Title

Owner

Phone

(301) 662-8866

Specialties & licenses 3

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MD2 enrollments

Enrollment records 2

Tax ID family

Longmeadow Optical2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Longmeadow Optical

  • Optometrist
  • Frederick, MD
  • NPI 1659760098
  NPD tax ID

Practitioners 2

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.

• Dawn Gill, OD

  • Optometrist
  • Frederick, MD
  • NPI 1417986233
  Medicare reassignment Care Compare group NPD Authorized official
• Jennifer Lyn Chen, O.D.

  • Optometrist
  • Frederick, MD
  • NPI 1386857100
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332288000000",
    "number": "1861529240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7420 HAYWARD RD STE 202",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217022509",
            "telephone_number": "301-662-8866",
            "fax_number": "301-293-6133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7420 HAYWARD RD STE 202",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217022509",
            "telephone_number": "301-662-8866",
            "fax_number": "301-293-6133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGMEADOW OPTICAL, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2012-03-21",
        "status": "A",
        "authorized_official_last_name": "GILL",
        "authorized_official_first_name": "DAWN",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-662-8866",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA1338",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA0646",
            "primary": false
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "MD",
            "license": "10199942",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "LR80LO",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FEP",
            "identifier": "B012",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "LR80LO",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DD3301",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Logistics Gap LLC
• Barbara Lohman-Flynn, LCSW-C
• Kayli Loiselle, PT
• Kim Marie Long, LCPC
• Longmeadow Optical
• Trishia Lopacienski, M.S., CCC-SLP
• Natalie Spencer Lopez-Barnard, LGPC, NCC
• Yvette M Lopez-Warren, M.D.
• Alexis N Lopez, CCC-SLP
• Fabian Lopez, PT

• Eyewear Supplier in Frederick, MD
• Providers in Frederick, MD by specialty
• Eyewear Supplier in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.