1. Home
  2. Directory
  3. Ohio
  4. Fort Recovery
  5. Optometrist
  6. NPI Profile

GRAND LAKE EYECARE, LLC
NPI 1487083697
Optometrist in Fort Recovery, OH

Active since November 07, 2013CLIA 36D2140049 · Waiver
130 N. WAYNE ST, FORT RECOVERY, OH 45846(419) 375-5665(419) 375-5667 Get Directions Write a Review

NPPES record last updated: November 7, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Grand Lake Eyecare, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GRAND LAKE EYECARE, LLC (NPI 1487083697) is a healthcare organization registered as an optometrist in Fort Recovery, Ohio and active in the NPI registry since November 2013. The organization holds a CLIA Waiver certificate valid through November 13, 2027 and lists Brian Thomas Gerlach, Owner, as its authorized official.

NPPES Registry Identity

NPI1487083697
Entity TypeOrganization
Primary Taxonomy152W00000X
Legal Business NameGRAND LAKE EYECARE, LLC
Location Address130 N. WAYNE STFort Recovery, OH 45846-0645
Mailing AddressPo Box 645Fort Recovery, OH 45846-0645 · (419) 375-5665 · Fax (419) 375-5667
Phone(419) 375-5665
Fax(419) 375-5667
Organization SubpartYes
Authorized OfficialBrian Thomas GerlachOwner · (419) 586-3151
Enumeration DateNovember 7, 2013
✔ NPI 1487083697 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
130 N. WAYNE ST, Fort Recovery, OH 45846
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 36D2140049

Grand Lake Eyecare, LLC · Fort Recovery, OH
Active · expires Nov 13, 2027
CLIA Number36D2140049
Laboratory TypePhysician Office
Certificate Effective DateNovember 14, 2025
Certificate Expiration DateNovember 13, 2027
Laboratory DirectorBrian T. Gerlach
Laboratory Phone(419) 375-5656
Laboratory LocationGrand Lake Eyecare, LLC130 N Wayne St, Fort Recovery, OH 45846
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Grand Lake Eyecare, LLC's NPI number?

The NPI number for Grand Lake Eyecare, LLC is 1487083697. It was assigned to this organization in the NPPES registry on November 7, 2013.

Where is Grand Lake Eyecare, LLC located?

Grand Lake Eyecare, LLC is located at 130 N. Wayne St, Fort Recovery, OH 45846. The listed phone number is (419) 375-5665.

What is Grand Lake Eyecare, LLC's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Does Grand Lake Eyecare, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 36D2140049) is associated with this NPI, valid through November 13, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Grand Lake Eyecare, LLC was last updated on November 7, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.