NPIMap

Organization Active NPI

Reynoldsburg Vision Associates Inc

  • Optometrist
  • Reynoldsburg, OH
National Provider Identifier
1871774679
Registry record updated Dec 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3318 AND 4542 Issued in OH
Legal business name
REYNOLDSBURG VISION ASSOCIATES INC
Practice address
7721 E Main St
Reynoldsburg, OH 43068-1211
Phone
(614) 861-0950
Fax
(614) 861-5665
NPI assigned
Nov 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2007

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

Authorized official

Name
Mrs. Roberta Jean Wilson
Title
Secretary/Treasurer
Phone
(614) 861-0950

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 3318 AND 4542 OH Primary

Addresses

Primary practice location

7721 E Main St
Reynoldsburg, OH 43068-1211

Mailing address

7721 E Main St
Reynoldsburg, OH 43068-1211
Phone (614) 861-0950

Other identifiers 1

IdentifierTypeStateIssuer
0630130001OtherOHMEDICARE B DME MAC

Other names 1

  • EYECARE ASSOCIATES Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050923001020 OH Part B Supplier - Clinic/Group Practice 3375577711 Receives reassigned benefits from 4 practitioners
Practice locations: Reynoldsburg, OH
O20100930002152 OH DME Supplier - Pharmacy 3375577711 Practice locations: Reynoldsburg, OH

National Provider Directory

National Provider Directory

Locations

7721 E Main St
Reynoldsburg, OH 43068
Phone (614) 861-0950

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1195516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196726400000",
    "number": "1871774679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7721 E MAIN ST",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430681211",
            "telephone_number": "614-861-0950",
            "fax_number": "614-861-5665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7721 E MAIN ST",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430681211",
            "telephone_number": "614-861-0950",
            "fax_number": "614-861-5665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REYNOLDSBURG VISION ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-20",
        "last_updated": "2007-12-04",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "ROBERTA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "SECRETARY/TREASURER",
        "authorized_official_telephone_number": "614-861-0950",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3318 AND 4542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE B DME MAC",
            "identifier": "0630130001",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EYECARE ASSOCIATES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Reynoldsburg, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2007; 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.