NPIMap

Organization Active NPI

Spectacle Shoppe LLC

  • Optician
  • South Charleston, WV
National Provider Identifier
1962653923
Registry record updated Jan 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
82110 Issued in WV
Legal business name
SPECTACLE SHOPPE LLC
Practice address
4513 Maccorkle Ave SW
South Charleston, WV 25309-1408
Phone
(304) 768-7371
Fax
(304) 720-3628
NPI assigned
Oct 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2011

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

Authorized official

Name
Dr. Nicole Rashid, MD
Title
Manager
Phone
(304) 768-7371

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OpticianGroup: 193400000X SINGLE SPECIALTY GROUP 156FX1800X 82110 WV Primary

Addresses

Primary practice location

4513 Maccorkle Ave SW
South Charleston, WV 25309-1408

Mailing address

4513 Maccorkle Ave SW
South Charleston, WV 25309-1408
Phone (304) 768-7371

National Provider Directory

National Provider Directory

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": "1223424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294876800000",
    "number": "1962653923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4513 MACCORKLE AVE SW",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091408",
            "telephone_number": "304-768-7371",
            "fax_number": "304-720-3628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4513 MACCORKLE AVE SW",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091408",
            "telephone_number": "304-768-7371",
            "fax_number": "304-720-3628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTACLE SHOPPE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-08",
        "last_updated": "2011-01-13",
        "status": "A",
        "authorized_official_last_name": "RASHID",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "304-768-7371",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "WV",
            "license": "82110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2011; 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.