The Optic Nerve, Inc.

Primary specialty

OpticianTaxonomy code 156FX1800X

License

31TD00342201 Issued in NJ

Legal business name

THE OPTIC NERVE, INC.

Doing business as

Pearle Vision

Practice address

163 Route 73 S
Marlton, NJ 08053-4120

Phone

(856) 985-1300

Fax

(856) 985-1346

NPI assigned

Dec 11, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Colin D. Yoder

Title

Optician/Owner

Phone

(856) 985-1300

Specialties & licenses 2

Addresses

Other names 1

• Pearle Vision Doing business as

Locations

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

{
    "created_epoch": "1418256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418256000000",
    "number": "1871991570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 ROUTE 73 S",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534120",
            "telephone_number": "856-985-1300",
            "fax_number": "856-985-1346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 ROUTE 73 S",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534120",
            "telephone_number": "856-985-1300",
            "fax_number": "856-985-1346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE OPTIC NERVE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-11",
        "last_updated": "2014-12-11",
        "status": "A",
        "authorized_official_last_name": "YODER",
        "authorized_official_first_name": "COLIN",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "OPTICIAN/OWNER",
        "authorized_official_telephone_number": "856-985-1300",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "156FC0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Contact Lens",
            "state": "NJ",
            "license": "31TD00342201",
            "primary": false
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "NJ",
            "license": "31TD00342201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pearle Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optician in Marlton, NJ
• Providers in Marlton, NJ by specialty
• Optician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2014; 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.