NPIMap

Organization Active NPI

Customeyes Vision Center, Inc.

  • Optometrist
  • West Chester, OH
National Provider Identifier
1962825802
Registry record updated Jan 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6170 Issued in OH
Legal business name
CUSTOMEYES VISION CENTER, INC.
Doing business as
Liberty EyeCare
Practice address
7604 Cox LN
West Chester, OH 45069-6547
Phone
(513) 759-5100
Fax
(513) 759-5801
NPI assigned
Jan 29, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2014

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

Authorized official

Name
Dr. Adam Joseph WoodNPI 1558626788
Title
Optometrist
Phone
(513) 759-5100

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 6170 OH Primary

Addresses

Primary practice location

7604 Cox LN
West Chester, OH 45069-6547

Mailing address

7604 Cox LN
West Chester, OH 45069-6547
Phone (513) 759-5100

Other names 1

  • Liberty EyeCare Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140408001342 OH Part B Supplier - Clinic/Group Practice 8123250040 Receives reassigned benefits from 3 practitioners
Practice locations: West Chester, OH

National Provider Directory

National Provider Directory

Locations

7580 Cox Ln
West Chester, OH 45069
Phone (513) 759-5100

Practitioners & affiliated clinicians

Practitioners 5

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": "1390953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390953600000",
    "number": "1962825802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7604 COX LN",
            "city": "WEST CHESTER",
            "state": "OH",
            "postal_code": "450696547",
            "telephone_number": "513-759-5100",
            "fax_number": "513-759-5801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7604 COX LN",
            "city": "WEST CHESTER",
            "state": "OH",
            "postal_code": "450696547",
            "telephone_number": "513-759-5100",
            "fax_number": "513-759-5801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOMEYES VISION CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-29",
        "last_updated": "2014-01-29",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "ADAM",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "513-759-5100",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OH",
            "license": "6170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Liberty EyeCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Chester, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2014; 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.

Verify at the official NPI Registry.