Organization Active NPI

Eye Care & Surgery Assoc., Inc.

  • Ophthalmology Physician
  • Sidney, OH
National Provider Identifier
1992858450
Registry record updated Feb 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
34003529W Issued in OH
Legal business name
EYE CARE & SURGERY ASSOC., INC.
Practice address
915 Michigan St
Wilson Medical Building Ste 101
Sidney, OH 45365-2401
Phone
(937) 492-8040
Fax
(937) 492-7447
NPI assigned
Jan 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2012

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

Authorized official

Name
Dr. John J Wilding, D.O.
Title
President
Phone
(937) 492-8040

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 34003529W OH Primary

Addresses

Primary practice location

915 Michigan St
Wilson Medical Building Ste 101
Sidney, OH 45365-2401

Mailing address

915 Michigan St
Wilson Medical Building Ste 101
Sidney, OH 45365-2401
Phone (937) 492-8040

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040510000638 OH Part B Supplier - Clinic/Group Practice 6507855145 Receives reassigned benefits from 3 practitioners
Practice locations: Bellefontaine, OH; Celina, OH; Sidney, OH; Troy, OH

National Provider Directory

National Provider Directory

Locations

715 Rush Ave
Bellefontaine, OH 43311
Phone (937) 593-3937

801 Pro Dr
Ste F
Celina, OH 45822

915 W Michigan
Cincinnati, OH 45263

915 W Michigan St
Cincinnati, OH 45263

6557 Brandt Pike
Huber Heights, OH 45424
Phone (937) 236-1770

915 Michigan St
Ste 101
Sidney, OH 45365
Phone (937) 492-8040

2901 Fair Rd
Sidney, OH 45365
Phone (937) 492-6900

1935 Prime Ct
Troy, OH 45373

321 W Main St
Van Wert, OH 45891
Phone (419) 238-5503

Interoperability endpoints

  • Direct secure messaging: sstorck@ohvision.intellechartdirect.net
  • Direct secure messaging: cjohnson@ohvision.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 9

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": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328572800000",
    "number": "1992858450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 MICHIGAN ST",
            "address_2": "WILSON MEDICAL BUILDING STE 101",
            "city": "SIDNEY",
            "state": "OH",
            "postal_code": "453652401",
            "telephone_number": "937-492-8040",
            "fax_number": "937-492-7447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 MICHIGAN ST",
            "address_2": "WILSON MEDICAL BUILDING STE 101",
            "city": "SIDNEY",
            "state": "OH",
            "postal_code": "453652401",
            "telephone_number": "937-492-8040",
            "fax_number": "937-492-7447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE CARE & SURGERY ASSOC., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2012-02-07",
        "status": "A",
        "authorized_official_last_name": "WILDING",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "937-492-8040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "OH",
            "license": "34003529W",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sidney, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2012; 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.