NPIMap

Organization Active NPI

Eye Street Optical Inc

  • Optician
  • Chantilly, VA
National Provider Identifier
1922200096
Registry record updated Oct 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
1101 000766 Issued in VA
Legal business name
EYE STREET OPTICAL INC
Practice address
3910 Centreville Rd
Suite 100
Chantilly, VA 20151-3279
Phone
(703) 830-6377
Fax
(703) 263-0326
NPI assigned
Jun 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2008

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

Authorized official

Name
Kathryn Berg Fritzke, OPTICIAN
Title
Optician Owner
Phone
(703) 830-6377

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OpticianGroup: 193400000X SINGLE SPECIALTY GROUP 156FX1800X 1101 000766 VA Primary

Addresses

Primary practice location

3910 Centreville Rd
Suite 100
Chantilly, VA 20151-3279

Mailing address

3910 Centreville Rd
Suite 100
Chantilly, VA 20151-3279
Phone (703) 830-6377

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223424000000",
    "number": "1922200096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3910 CENTREVILLE RD",
            "address_2": "SUITE 100",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201513279",
            "telephone_number": "703-830-6377",
            "fax_number": "703-263-0326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3910 CENTREVILLE RD",
            "address_2": "SUITE 100",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201513279",
            "telephone_number": "703-830-6377",
            "fax_number": "703-263-0326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE STREET OPTICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-01",
        "last_updated": "2008-10-08",
        "status": "A",
        "authorized_official_last_name": "FRITZKE",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_middle_name": "BERG",
        "authorized_official_title_or_position": "OPTICIAN OWNER",
        "authorized_official_telephone_number": "703-830-6377",
        "authorized_official_credential": "OPTICIAN"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "VA",
            "license": "1101 000766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chantilly, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2008; 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.