NPIMap

Organization Active NPI

Optibarn

  • Optometrist
  • Elizabethtown, PA
National Provider Identifier
1932384336
Registry record updated Jan 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OE007020T Issued in PA
Legal business name
OPTIBARN
Practice address
20 College Ave
Elizabethtown, PA 17022
Phone
(717) 367-8234
Fax
(717) 367-1884
NPI assigned
Jan 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2008

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

Authorized official

Name
Dr. Ty M Graden, ODNPI 1891739066
Title
Optometrist
Phone
(717) 367-1883

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OE007020T PA Primary

Addresses

Primary practice location

20 College Ave
Elizabethtown, PA 17022

Mailing address

20 College Ave
Elizabethtown, PA 17022
Phone (717) 367-8234

National Provider Directory

National Provider Directory
Tax ID family
Optibarn2 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.

Locations

20 E College Ave
Elizabethtown, PA 17022
Phone (717) 367-8234

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1199318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199318400000",
    "number": "1932384336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 COLLEGE AVE",
            "city": "ELIZABETHTOWN",
            "state": "PA",
            "postal_code": "17022",
            "telephone_number": "717-367-8234",
            "fax_number": "717-367-1884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 COLLEGE AVE",
            "city": "ELIZABETHTOWN",
            "state": "PA",
            "postal_code": "17022",
            "telephone_number": "717-367-8234",
            "fax_number": "717-367-1884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIBARN",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-03",
        "last_updated": "2008-01-03",
        "status": "A",
        "authorized_official_last_name": "GRADEN",
        "authorized_official_first_name": "TY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "717-367-1883",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OE007020T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.