Edmonds Optician of McLean Inc.

Primary specialty

OpticianTaxonomy code 156FX1800X

Legal business name

EDMONDS OPTICIAN OF MCLEAN INC.

Practice address

6832 Old Dominion Dr
McLean, VA 22101-3887

Phone

(703) 790-0377

Fax

(703) 790-8594

NPI assigned

Dec 6, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Samuel G. Tate

Title

President

Phone

(703) 790-0377

Specialties & licenses 1

Addresses

Practitioners 1

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

• Susan Robinson Wiley, OD

  • Optometrist
  • MC Lean, VA
  • NPI 1477725950
  NPD (past)

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210032000000",
    "number": "1861551020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6832 OLD DOMINION DR",
            "city": "MCLEAN",
            "state": "VA",
            "postal_code": "221013887",
            "telephone_number": "703-790-0377",
            "fax_number": "703-790-8594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6832 OLD DOMINION DR",
            "city": "MCLEAN",
            "state": "VA",
            "postal_code": "221013887",
            "telephone_number": "703-790-0377",
            "fax_number": "703-790-8594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDMONDS OPTICIAN OF MCLEAN INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2008-05-06",
        "status": "A",
        "authorized_official_last_name": "TATE",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-790-0377",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Regina Devlin, CPNP, IBCLC, PMHS
• Mohammad Reza Didehvar, MD
• Roberta Mae Dittmer
• Christy Dixon
• Dr. Wendy C Garson, P.C.
• Brian Egan, MD
• Nasrin Ejtemaee, M.D.
• John Robert Eklund, RPH
• Lisa O. Elkin, PSY.D.
• Neda Etessam, DDS

• Optician in McLean, VA
• Providers in McLean, VA by specialty
• Optician in Virginia

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