NPIMap

Organization Active NPI

MPG LLC

Doing business as Shenandoah Eye Care

  • Optometrist
  • Harrisonburg, VA
National Provider Identifier
1912029786
Registry record updated Jan 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MPG LLC
Doing business as
Shenandoah Eye Care
Practice address
1870 Reservoir St
Harrisonburg, VA 22801-8742
Phone
(540) 434-6622
Fax
(540) 434-4187
NPI assigned
Apr 4, 2007
Last updated
Jan 12, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2010

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

Authorized official

Name
Dr. Michael P Gowen Sr., ODNPI 1831170026
Title
Owner
Phone
(540) 434-6622

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
Optometrist 152W00000X VA Primary

Addresses

Primary practice location

1870 Reservoir St
Harrisonburg, VA 22801-8742

Mailing address

1870 Reservoir St
Harrisonburg, VA 22801
Phone (540) 434-6622

Other identifiers 1

IdentifierTypeStateIssuer
1831170026MedicaidVA

Other names 1

  • Shenandoah Eye Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
MPG LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the 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": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263254400000",
    "number": "1912029786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1870 RESERVOIR ST",
            "city": "HARRISONBURG",
            "state": "VA",
            "postal_code": "22801",
            "telephone_number": "540-434-6622",
            "fax_number": "540-434-4187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1870 RESERVOIR ST",
            "city": "HARRISONBURG",
            "state": "VA",
            "postal_code": "228018742",
            "telephone_number": "540-434-6622",
            "fax_number": "540-434-4187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MPG LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2010-01-12",
        "status": "A",
        "authorized_official_last_name": "GOWEN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "540-434-6622",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1831170026",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shenandoah Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Harrisonburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2010; 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.