NPIMap

Organization Active NPI

Prospect Vision Care Inc

  • Optometrist
  • Prospect, OH
National Provider Identifier
1881852804
Registry record updated Jul 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4919 Issued in OH
Legal business name
PROSPECT VISION CARE INC
Practice address
100 E Water St
Prospect, OH 43342-0034
Phone
(740) 494-2999
Fax
(740) 494-2999
NPI assigned
May 27, 2008
Last updated
Jul 27, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2009

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

Authorized official

Name
Dr. Virginia Chetverikov, O.D.NPI 1093745861
Title
Owner
Phone
(740) 494-2999

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 4919 OH Primary

Addresses

Primary practice location

100 E Water St
Prospect, OH 43342-0034

Mailing address

100 E Water St
PO Box 34
Prospect, OH 43342-0034
Phone (740) 494-2999

Other identifiers 1

IdentifierTypeStateIssuer
2067963MedicaidOH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1211846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248652800000",
    "number": "1881852804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E WATER ST",
            "address_2": "PO BOX 34",
            "city": "PROSPECT",
            "state": "OH",
            "postal_code": "433420034",
            "telephone_number": "740-494-2999",
            "fax_number": "740-494-2999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E WATER ST",
            "city": "PROSPECT",
            "state": "OH",
            "postal_code": "433420034",
            "telephone_number": "740-494-2999",
            "fax_number": "740-494-2999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSPECT VISION CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-27",
        "last_updated": "2009-07-27",
        "status": "A",
        "authorized_official_last_name": "CHETVERIKOV",
        "authorized_official_first_name": "VIRGINIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "740-494-2999",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2067963",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prospect, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2009; 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.