MPG LLC – Optometrist in Staunton, VA

Key facts

NPI: 1962574673
Entity type: Organization (NPI type 2)
Primary specialty: Optometrist 152W00000X
License: 0618000690 (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
Organization subpart: No

Authorized official

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

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

MPG LLC Optometrist · Harrisonburg, VA · NPI 1912029786

NPD tax ID

Practitioners 5

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

Erdal Bekir Adam, OD Optometrist · Fishersville, VA · NPI 1861473050

NPD (past) OPTOMETRIST
Stefan Kristoph Young, O.D. Optometrist · Lake Ridge, VA · NPI 1336219211

NPD (past) OPTOMETRIST
Cory Partlow, O.D. Optometrist · Black Mountain, NC · NPI 1396972063

NPD (past) OPTOMETRIST
Jennifer Dawn Partlow, O.D. Optometrist · Black Mountain, NC · NPI 1588826424

NPD (past) OPTOMETRIST
Timothy Ralph Quinlan, PH.D, O.D. Optometrist · Kingston, NY · NPI 1811082621

NPD (past) OPTOMETRIST

National Provider Directory

Tax ID family: MPG LLC (2 organizations share this tax ID)

Locations

182 Neff Ave
Ste 11
Harrisonburg, VA 22801

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Optometrist Group: 193400000X SINGLE SPECIALTY GROUP	152W00000X	0618000690	VA	Yes

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

Shenandoah Eye Care Other name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 11, 2008.

{
    "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

All providers in Staunton, VA · Optometrist in Virginia

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 11, 2008. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.