Dr. Christian a. King Optometrist, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

4116T1056 Issued in OH

Legal business name

DR. CHRISTIAN A. KING OPTOMETRIST, LLC

Practice address

1001 S. Defiance St.
Archbold, OH 43502-0038

Phone

(419) 445-5436

Fax

(419) 446-4818

NPI assigned

Oct 6, 2008

Last updated

Nov 13, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Christian A King, ODNPI 1215955570

Title

Owner

Phone

(419) 445-5436

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Christian A. King, OD Former legal business name

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Practitioners 2

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.

• Christian A King, O.D.

  • Optometrist
  • Archbold, OH
  • NPI 1215955570
  Medicare reassignment NPD Authorized official
• Jacquelyn Gayle Short, O.D.

  • Optometrist
  • Archbold, OH
  • NPI 1588072003
  NPD (past)

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

{
    "created_epoch": "1223251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573603200000",
    "number": "1891946158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 S. DEFIANCE ST.",
            "address_2": "PO BOX 38",
            "city": "ARCHBOLD",
            "state": "OH",
            "postal_code": "435020038",
            "telephone_number": "419-445-5436",
            "fax_number": "419-446-4818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 S. DEFIANCE ST.",
            "city": "ARCHBOLD",
            "state": "OH",
            "postal_code": "435020038",
            "telephone_number": "419-445-5436",
            "fax_number": "419-446-4818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. CHRISTIAN A. KING OPTOMETRIST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-06",
        "last_updated": "2019-11-13",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "CHRISTIAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "419-445-5436",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4116T1056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0768129",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "7769130001",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Christian A. King, OD",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Erin Dilorenzo
• Kimberly Hazel Drewes, RNC
• Cara Drummelsmith
• Allison Jean Durham, P.T., D.P.T, R.N.
• Teresa Lynn Eicher, LISW-S
• Rebecca Elkins, LSW

• Optometrist in Archbold, OH
• Providers in Archbold, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2019; 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.