Individual provider Active NPI

Tonya Vaughn

  • Optician
  • Beachwood, OH
National Provider Identifier
1942279708
Registry record updated Sep 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
5656 Issued in OH
Practice address
24800 Chagrin Blvd
Suite 211
Beachwood, OH 44122-5648
Phone
(216) 896-0316
Fax
(216) 896-9997
NPI assigned
Mar 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 5656 OH Primary

Addresses

Primary practice location

24800 Chagrin Blvd
Suite 211
Beachwood, OH 44122-5648

Mailing address

24800 Chagrin Blvd
Suite 211
Beachwood, OH 44122-5648
Phone (216) 896-0316

Other identifiers 4

IdentifierTypeStateIssuer
62383OtherOHDAVIS VISION
0188872MedicaidOH
00002660OtherOHWELLCARE
341883505026OtherOHCARESOURCE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930095677 OH DME Supplier - Optician 8729286984 Practice locations: Beachwood, OH

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5656OHMDOptician

Practice roles

OrganizationSpecialtyStatusNew patients
Eyewear International/TV Opticians CurrentSince Feb 5, 2009 Accepting new patients
The Dorothy L. Vaughn Behavioral and Mental Health Services, LLC. Past Accepting new patients

Locations

23611 Chagrin Blvd
Ste 120
Beachwood, OH 44122
Phone (216) 360-9343

24800 Chagrin Blvd
Ste 211
Beachwood, OH 44122
Phone (216) 896-0316

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316476800000",
    "number": "1942279708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24800 CHAGRIN BLVD",
            "address_2": "SUITE 211",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225648",
            "telephone_number": "216-896-0316",
            "fax_number": "216-896-9997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24800 CHAGRIN BLVD",
            "address_2": "SUITE 211",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225648",
            "telephone_number": "216-896-0316",
            "fax_number": "216-896-9997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "TONYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-15",
        "last_updated": "2011-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "OH",
            "license": "5656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS VISION",
            "identifier": "62383",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0188872",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "00002660",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE",
            "identifier": "341883505026",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.