NPIMap

Organization Active NPI

Central Penn Vision Associates, PC

  • Optometrist
  • State College, PA
National Provider Identifier
1902025182
Registry record updated May 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG000861 Issued in PA
Legal business name
CENTRAL PENN VISION ASSOCIATES, PC
Practice address
1363 N Atherton St
State College, PA 16803-2932
Phone
(814) 238-2868
Fax
(814) 238-1851
NPI assigned
Apr 25, 2007
Last updated
May 14, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2013

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

Authorized official

Name
Dr. Stephanie Fozard, O.D.
Title
Doctor
Phone
(814) 238-2862

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OEG000861 PA Primary

Addresses

Primary practice location

1363 N Atherton St
State College, PA 16803-2932

Mailing address

1363 N Atherton St
State College, PA 16803-2932
Phone (814) 238-2868

National Provider Directory

National Provider Directory

Locations

201 E Beaver Ave
State College, PA 16801
Phone (814) 238-2862

Practitioners & affiliated clinicians

Practitioners 3

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": "1177459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368489600000",
    "number": "1902025182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1363 N ATHERTON ST",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168032932",
            "telephone_number": "814-238-2868",
            "fax_number": "814-238-1851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1363 N ATHERTON ST",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168032932",
            "telephone_number": "814-238-2868",
            "fax_number": "814-238-1851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL PENN VISION ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-25",
        "last_updated": "2013-05-14",
        "status": "A",
        "authorized_official_last_name": "FOZARD",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "814-238-2862",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in State College, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2013; 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.