Organization Active NPI

North Main Eyecare, LLC

  • Optometrist
  • Bellefontaine, OH
National Provider Identifier
1881068328
Registry record updated Nov 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
NORTH MAIN EYECARE, LLC
Practice address
1008 N Main St
Bellefontaine, OH 43311-2371
Phone
(937) 599-5315
Fax
(937) 599-1185
NPI assigned
Nov 20, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2015

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

Authorized official

Name
Christopher Morgan Gamble, ODNPI 1356412886
Title
Optometrist
Phone
(937) 599-5315

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

1008 N Main St
Bellefontaine, OH 43311-2371

Mailing address

1008 N Main St
Bellefontaine, OH 43311-2371
Phone (937) 599-5315

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160129000723 OH Part B Supplier - Clinic/Group Practice 3870896509 Receives reassigned benefits from 1 practitioner
Practice locations: Bellefontaine, OH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1447977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447977600000",
    "number": "1881068328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 N MAIN ST",
            "city": "BELLEFONTAINE",
            "state": "OH",
            "postal_code": "433112371",
            "telephone_number": "937-599-5315",
            "fax_number": "937-599-1185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 N MAIN ST",
            "city": "BELLEFONTAINE",
            "state": "OH",
            "postal_code": "433112371",
            "telephone_number": "937-599-5315",
            "fax_number": "937-599-1185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH MAIN EYECARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-20",
        "last_updated": "2015-11-20",
        "status": "A",
        "authorized_official_last_name": "GAMBLE",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "MORGAN",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "937-599-5315",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellefontaine, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2015; 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.