Southington Optometric Care, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

SOUTHINGTON OPTOMETRIC CARE, LLC

Practice address

27 Meriden Ave
Southington, CT 06489-3234

Phone

(860) 628-9937

Fax

(860) 621-4911

NPI assigned

Sep 20, 2007

Last updated

May 10, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Heather L Theriault, ODNPI 1548312440

Title

Manager/Member

Phone

(860) 628-9937

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Southington Optometric Care, LLC

  • Optometrist
  • Terryville, CT
  • NPI 1134315427

  O20091117000546

  Same enrollment

Locations

Practitioners 3

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.

• Heather Lavallee Theriault, OD

  • Optometrist
  • Southington, CT
  • NPI 1548312440
  Medicare reassignment NPD Authorized official
• John L Ceplenski, DDS

  • General Practice Dentistry
  • Southington, CT
  • NPI 1245494327
  NPD (past)
• Lauren Beth Colite, O.D.

  • Optometrist
  • Hartford, CT
  • NPI 1487883484
  NPD (past)

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

{
    "created_epoch": "1190246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462838400000",
    "number": "1972799260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 MERIDEN AVE",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064893234",
            "telephone_number": "860-628-9937",
            "fax_number": "860-621-4911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 MERIDEN AVE",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064893234",
            "telephone_number": "860-628-9937",
            "fax_number": "860-621-4911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHINGTON OPTOMETRIC CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-20",
        "last_updated": "2016-05-10",
        "status": "A",
        "authorized_official_last_name": "THERIAULT",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGER/MEMBER",
        "authorized_official_telephone_number": "860-628-9937",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004199354",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southington Care Center
• Southington Care Center
• Southington Chiropractic Center, P.C.
• Southington Dental Assoicates PC
• Southington Eye Associates, P.C.
• Southington Oral & Maxillofacial Surgeons, PC
• Southington Pediatric Associates LLC
• Southington Urgent Care
• Michael Anthony Sposato, PA-C
• Sprinkles of Hope Counseling Center, LLC

• Optometrist in Southington, CT
• Providers in Southington, CT by specialty
• Optometrist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2016; 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.