NPIMap

Organization Active NPI

Eye Physicians & Facial Plastic Surgery, LLC

  • Ophthalmic Plastic and Reconstructive Surgery Physician
  • Dayton, OH
National Provider Identifier
1942655477
Registry record updated May 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmic Plastic and Reconstructive Surgery PhysicianTaxonomy code 207WX0200X
License
35-071393W Issued in OH
Legal business name
EYE PHYSICIANS & FACIAL PLASTIC SURGERY, LLC
Practice address
5900 N Main St
Dayton, OH 45415-3150
Phone
(937) 274-2733
Fax
(937) 274-2737
NPI assigned
May 3, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2016

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

Authorized official

Name
Kevin J Watt, MDNPI 1326025743
Title
Owner
Phone
(937) 274-2733

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
Ophthalmic Plastic and Reconstructive Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207WX0200X 35-071393W OH Primary

Addresses

Primary practice location

5900 N Main St
Dayton, OH 45415-3150

Mailing address

PO Box 1314
Dayton, OH 45401-1314
Phone (937) 274-2733

Other identifiers 1

IdentifierTypeStateIssuer
2111324MedicaidOH

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

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": "1462233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462233600000",
    "number": "1942655477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1314",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454011314",
            "telephone_number": "937-274-2733",
            "fax_number": "937-274-2737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 N MAIN ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454153150",
            "telephone_number": "937-274-2733",
            "fax_number": "937-274-2737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE PHYSICIANS & FACIAL PLASTIC SURGERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-03",
        "last_updated": "2016-05-03",
        "status": "A",
        "authorized_official_last_name": "WATT",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-274-2733",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207WX0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "OH",
            "license": "35-071393W",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2111324",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2016; 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.