NPIMap

Organization Active NPI

Canton Vision Center, Inc.

Doing business as Canton Vision Center

  • Optometrist
  • Baltimore, MD
National Provider Identifier
1992899967
Registry record updated Apr 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA 1553 Issued in MD
Legal business name
CANTON VISION CENTER, INC.
Doing business as
Canton Vision Center
Practice address
3221 Odonnell St
Baltimore, MD 21224-5040
Phone
(410) 534-2015
Fax
(410) 534-2019
NPI assigned
Oct 3, 2006
Last updated
Apr 14, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2015

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

Authorized official

Name
Dr. Ryan Quentin Beveridge, O.D.NPI 1710905880
Title
Optometrist
Phone
(410) 534-2015

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA 1553 MD Primary

Addresses

Primary practice location

3221 Odonnell St
Baltimore, MD 21224-5040

Mailing address

3221 Odonnell St
Baltimore, MD 21224-5040
Phone (410) 534-2015

Other names 1

  • Canton Vision Center Doing business as

National Provider Directory

National Provider Directory

Locations

3221 Odonnell St
Baltimore, MD 21224
Phone (410) 534-2015

8727 Flower Ave
Silver Spring, MD 20901
Phone (301) 585-6363

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428969600000",
    "number": "1992899967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3221 ODONNELL ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212245040",
            "telephone_number": "410-534-2015",
            "fax_number": "410-534-2019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3221 ODONNELL ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212245040",
            "telephone_number": "410-534-2015",
            "fax_number": "410-534-2019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANTON VISION CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2015-04-14",
        "status": "A",
        "authorized_official_last_name": "BEVERIDGE",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "QUENTIN",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "410-534-2015",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA 1553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Canton Vision Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.