OLDE TYME OPTICAL (NPI# 1659759918) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659759918 |
| Entity Type | Organization |
| Organization Name | OLDE TYME OPTICAL |
| Practice Address |
100 N. 8th St E. Suite 264 E. St. Louis IL 62201 |
| Practice Telephone | 6182742020 |
| Enumeration Date | 2015-05-07 |
| Last Update Date | 2015-05-07 |
| Authorized Official Name | MR. DAVID ANTONE BLISSENBACH (OWNER) |
| Authorized Official Telephone | 6182742020 |
| Is Organization Subpart | Y |
| Parent Organization Name | OLDE TYME OPTICAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 156FX1800X |
Technician/Technologist Specialization: Optician |
Eye and Vision Services Providers |
| Street Address |
100 N. 8TH ST E. SUITE 264 |
| City | E. ST. LOUIS |
| State | IL |
| Zip Code | 62201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417593724 | Brighter Hope Inc | Clinic/Center | 1400 E. Broadway, East St Louis, IL 62201 | 2019-11-21 |
| 1689890006 | Carrie Ann Settlemoir | Chiropractor | 699 Rte. 203, Suite 101, E.st.louis, IL 62201 | 2007-04-17 |
| 1659417582 | Brett Irvin | Dentist | 1511 East Broadway, St Louis, IL 62201 | 2007-01-29 |
| 1386700771 | Laura A. Collier | Registered Nurse | 540 North 6th Street, East Saint Louis, IL 62201 | 2006-12-29 |
| 1366508053 | Yetzenia Aramis Arauz | Registered Nurse | 2568 North 41st Street, Fairmont City, IL 62201 | 2006-12-28 |
| 1255426466 | Hee Man Song | Specialist | 100 North 8th Street, Suite 232, East St Louis, IL 62201 | 2006-10-04 |
| 1821109737 | Richard Joseph Fleming | Physical Therapist | 144 Lincoln Place Ct, Suite 1, Belleville, IL 62201 | 2006-08-31 |
| 1942510508 | Southern Illinois Health Care Foundation, Inc. | Family Medicine | 505 S 8th St, East Saint Louis, IL 62201 | 2010-10-18 |
| 1104157437 | United We Trust Home Care | Case Management | 327 Missouri Ave, Suite 300, East Saint Louis, IL 62201 | 2010-01-27 |
| 1437328283 | Comprehensive Mental Health Center of St. Clair County, Inc. | Clinic/Center | 505 S 8th St, East Saint Louis, IL 62201 | 2008-02-26 |
| Find all providers in zip 62201 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902445570 | Kami Optical Corp | Technician/Technologist | 1163 E Ogden Ave Ste 701, Naperville, IL 60563-8535 | 2019-12-31 |
| 1750847281 | National Vision Inc | Technician/Technologist | 750 S Rand Rd, Lake Zurich, IL 60047-2467 | 2019-02-20 |
| 1700364171 | National Vision Inc | Technician/Technologist | 4068 North Milwaukee Avenue, Chicago, IL 60641 | 2018-07-30 |
| 1720571615 | National Vision, Inc. | Technician/Technologist | 6931 Grand Ave Ste E2, Gurnee, IL 60031-1610 | 2018-06-14 |
| 1023528619 | Direct Healthcare Solutions LLC | Technician/Technologist | 1520 Fringetree Ln, Woodridge, IL 60517-4653 | 2017-10-09 |
| 1184140014 | Efp Opticians On Dearborn, LLC | Technician/Technologist | 1205 N Dearborn St, Chicago, IL 60610-2213 | 2017-08-22 |
| 1235668245 | Vision Man | Technician/Technologist | 8335 Grand Ave, River Grove, IL 60171-1434 | 2017-06-05 |
| 1033662200 | National Vision, Inc. | Technician/Technologist | 348 W Army Trail Rd, Suite 130, Bloomingdale, IL 60108-5608 | 2016-07-25 |
| 1780039115 | Wal-mart Stores, Inc. | Technician/Technologist | 365 Lake Marian Road, Carpentersville, IL 60110 | 2016-05-04 |
| 1346695392 | National Vision, Inc. | Technician/Technologist | 714 S Randall Rd, Algonquin, IL 60102-5915 | 2016-04-27 |
| Find all providers with the same taxonomy | ||||
| City | E. ST. LOUIS |
| Zip Code | 62201 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.