Active NPI
Theodore Horvat Sober, OD
- Optometrist
- Essex, MD
National Provider Identifier
1972560282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- TA0612
- Practice address
- 405 Stemmers Run Rd
Essex, MD 21221-3332 - Phone
- (410) 682-2888
- Fax
- (410) 682-9936
- NPI assigned
- Apr 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | TA0612 | MD | Primary |
Addresses
Primary practice location
405 Stemmers Run Rd
Essex, MD 21221-3332
Mailing address
405 Stemmers Run Rd
Essex, MD 21221-3332
Phone (410) 682-2888
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 801138900 | Medicaid | MD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1245888000000",
"number": "1972560282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "405 STEMMERS RUN RD",
"city": "ESSEX",
"state": "MD",
"postal_code": "212213332",
"telephone_number": "410-682-2888",
"fax_number": "410-682-9936"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "405 STEMMERS RUN RD",
"city": "ESSEX",
"state": "MD",
"postal_code": "212213332",
"telephone_number": "410-682-2888",
"fax_number": "410-682-9936"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOBER",
"first_name": "THEODORE",
"middle_name": "HORVAT",
"name_prefix": "Mr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-28",
"last_updated": "2009-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MD",
"license": "TA0612",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "801138900",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Essex, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.