Active NPI
Tonya Vaughn
- Optician
- Beachwood, OH
National Provider Identifier
1942279708
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 5656
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 62383 | Other | OH | DAVIS VISION |
| 0188872 | Medicaid | OH | |
| 00002660 | Other | OH | WELLCARE |
| 341883505026 | Other | OH | CARESOURCE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930095677 | OH | DME Supplier - Optician | 8729286984 | Practice locations: Beachwood, OH |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5656 | OH | MD | Optician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eyewear International/TV Opticians | Current | 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.
-
- Durable Medical Equipment & Medical Supplies
- Beachwood, OH
- NPI 1326271206
-
- Community/Behavioral Health Agency
- Las Vegas, NV
- NPI 1598221723
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.