NPIMap

Organization Active NPI

Omega Optical at Comcast, LLC

  • Optometrist
  • Philadelphia, PA
National Provider Identifier
1922388115
Registry record updated Aug 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
486987 Issued in PA
Legal business name
OMEGA OPTICAL AT COMCAST, LLC
Practice address
1701 JFK Blvd
Philadelphia, PA 19103-2838
Phone
(215) 564-1288
Fax
(215) 564-9037
NPI assigned
Aug 19, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2011

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

Authorized official

Name
Steve Davis
Title
Owner
Phone
(215) 564-1288

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 486987 PA Primary

Addresses

Primary practice location

1701 JFK Blvd
Philadelphia, PA 19103-2838

Mailing address

1701 JFK Blvd
Philadelphia, PA 19103-2838
Phone (215) 564-1288

Other names 1

  • Omega Optical at Comcast Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Omega Optical at Comcast Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1313712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313712000000",
    "number": "1922388115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 JFK BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191032838",
            "telephone_number": "215-564-1288",
            "fax_number": "215-564-9037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 JFK BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191032838",
            "telephone_number": "215-564-1288",
            "fax_number": "215-564-9037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMEGA OPTICAL AT COMCAST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-19",
        "last_updated": "2011-08-19",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-564-1288"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "PA",
            "license": "486987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Omega Optical at Comcast",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2011; 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.