North Coast Eye Care Vermilion, LLC
Organization Active NPI Optometrist · Vermilion, OH
NPI 1982900965 · NPPES record last updated Aug 23, 2012
Key facts
- NPI
- 1982900965
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- 4513 (OH)
- Legal business name
- NORTH COAST EYE CARE VERMILION, LLC
- Practice address
- 5491 Liberty Ave
Vermilion, OH 44089-1307 - Phone
- (440) 967-2020
- Fax
- (440) 967-3228
- NPI assigned
- Feb 8, 2011
- Organization subpart
- No
Authorized official
- Name
- Dr. David A Delprincipe, O.D.
- Title
- Owner
- Phone
- (440) 967-2020
Practitioners 3
-
Andrea Lynne Fisher, O.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120702000223 | OH | Part B Supplier - Clinic/Group Practice | 7012172794 |
Receives reassigned benefits from 1 practitioner Practice locations: Vermilion, OH |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | 4513 | OH | Yes |
Addresses
Primary practice location
5491 Liberty Ave
Vermilion, OH 44089-1307
Mailing address
5491 Liberty Ave
Vermilion, OH 44089-1307
Phone (440) 967-2020
NPI Registry JSON
{
"created_epoch": "1297123200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1345680000000",
"number": "1982900965",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5491 LIBERTY AVE",
"city": "VERMILION",
"state": "OH",
"postal_code": "440891307",
"telephone_number": "440-967-2020",
"fax_number": "440-967-3228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5491 LIBERTY AVE",
"city": "VERMILION",
"state": "OH",
"postal_code": "440891307",
"telephone_number": "440-967-2020",
"fax_number": "440-967-3228"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NORTH COAST EYE CARE VERMILION, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2011-02-08",
"last_updated": "2012-08-23",
"status": "A",
"authorized_official_last_name": "DELPRINCIPE",
"authorized_official_first_name": "DAVID",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "440-967-2020",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "O.D."
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": "OH",
"license": "4513",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Vermilion, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 23, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.