Organization Active NPI

Family Eyecare Associates, Inc.

  • Optometrist
  • Millersburg, OH
National Provider Identifier
1891717849
Registry record updated Jun 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
FAMILY EYECARE ASSOCIATES, INC.
Practice address
1275 Glen Dr
Millersburg, OH 44654-8958
Phone
(330) 674-6121
Fax
(330) 674-7409
NPI assigned
Jul 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2008

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

Authorized official

Name
Dr. James R Conway, OD
Title
President
Phone
(330) 674-6121

Specialties & licenses 1

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

Addresses

Primary practice location

1275 Glen Dr
Millersburg, OH 44654-8958

Mailing address

1275 Glen Dr
Millersburg, OH 44654-8958
Phone (330) 674-6121

Other identifiers 3

IdentifierTypeStateIssuer
0468088MedicaidOH
0468079MedicaidOH
0130478MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100112000022 OH Part B Supplier - Clinic/Group Practice 7315088465 Receives reassigned benefits from 2 practitioners
Practice locations: Millersburg, OH

National Provider Directory

National Provider Directory

Locations

1275 Glen Dr
Millersburg, OH 44654
Phone (330) 674-6121

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": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213142400000",
    "number": "1891717849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 GLEN DR",
            "city": "MILLERSBURG",
            "state": "OH",
            "postal_code": "446548958",
            "telephone_number": "330-674-6121",
            "fax_number": "330-674-7409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 GLEN DR",
            "city": "MILLERSBURG",
            "state": "OH",
            "postal_code": "446548958",
            "telephone_number": "330-674-6121",
            "fax_number": "330-674-7409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY EYECARE ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2008-06-11",
        "status": "A",
        "authorized_official_last_name": "CONWAY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-674-6121",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0468088",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0468079",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0130478",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Millersburg, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2008; 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.