Eyeball Optical Inc

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

1167 Issued in CT

Legal business name

EYEBALL OPTICAL INC

Practice address

458 Talcottville Rd
Vernon, CT 06066-4052

Phone

(860) 875-6156

Fax

(860) 871-3822

NPI assigned

Oct 6, 2006

Last updated

Oct 5, 2007By 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

Mr. Michael R Kelly, L.O.NPI 1043693468

Title

Pres

Phone

(860) 876-6156

Specialties & licenses 1

Addresses

Locations

Practitioners 4

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.

• Michael R Kelly

  • Optician
  • Vernon, CT
  • NPI 1043693468
  NPD (past) Authorized official
• Abby Kelly, OD

  • Optometrist
  • Vernon, CT
  • NPI 1669823910
  NPD (past)
• Juliet Alicia Plucinik, OD

  • Optometrist
  • Bristol, CT
  • NPI 1912685538
  NPD (past)
• James Smyth, O.D.

  • Optometrist
  • Vernon, CT
  • NPI 1013079706
  NPD (past)

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191542400000",
    "number": "1932296225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "458 TALCOTTVILLE RD",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060664052",
            "telephone_number": "860-875-6156",
            "fax_number": "860-871-3822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "458 TALCOTTVILLE RD",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060664052",
            "telephone_number": "860-875-6156",
            "fax_number": "860-871-3822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYEBALL OPTICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2007-10-05",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "860-876-6156",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "L.O."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "CT",
            "license": "1167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jesse Eisler, M.D.
• Empowered Professional Services
• Kristen English, DPT
• Ivy Erazo, LMSW
• Evolve With Enas LLC
• Ashkan Fahandej Saadi, DMD
• Janelle-Marie Lynch Fako, BCBA
• Family Affirmation Center for Treatment
• Family Affirmation Center for Treatment, LLC
• Family Services of Eastern Connecticut, LLC

• Eyewear Supplier in Vernon, CT
• Providers in Vernon, CT by specialty
• Eyewear Supplier in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2007; 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.