NPIMap

Organization Active NPI

MPG LLC

  • Optometrist
  • Staunton, VA
National Provider Identifier
1962574673
Registry record updated Jul 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618000690 Issued in VA
Legal business name
MPG LLC
Practice address
1412 N Augusta St
Staunton, VA 24401
Phone
(540) 885-0006
Fax
(540) 885-5276
NPI assigned
Nov 15, 2006
Last updated
Jul 11, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2008

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

Authorized official

Name
Dr. Michael P Gowen Sr., OD
Title
Owner
Phone
(540) 885-0006

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 0618000690 VA Primary

Addresses

Primary practice location

1412 N Augusta St
Staunton, VA 24401

Mailing address

1412 N Augusta St
Staunton, VA 24401
Phone (540) 885-0006

Other names 1

  • Shenandoah Eye Care Other name

National Provider Directory

National Provider Directory
Tax ID family
MPG LLC2 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.

  • MPG LLC

    dba Shenandoah Eye Care

    • Optometrist
    • Harrisonburg, VA
    • NPI 1912029786
    NPD tax ID

Locations

182 Neff Ave
Ste 11
Harrisonburg, VA 22801

1412 N Augusta St
Staunton, VA 24401
Phone (540) 885-0006

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215734400000",
    "number": "1962574673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412 N AUGUSTA ST",
            "city": "STAUNTON",
            "state": "VA",
            "postal_code": "24401",
            "telephone_number": "540-885-0006",
            "fax_number": "540-885-5276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 N AUGUSTA ST",
            "city": "STAUNTON",
            "state": "VA",
            "postal_code": "24401",
            "telephone_number": "540-885-0006",
            "fax_number": "540-885-5276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MPG LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2008-07-11",
        "status": "A",
        "authorized_official_last_name": "GOWEN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "540-885-0006",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618000690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shenandoah Eye Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Staunton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.